Natalizumab treatment for multiple sclerosis: updated recommendations for patient selection and monitoring.

Abstract

Natalizumab, a highly specific α4-integrin antagonist, is approved for treatment of patients with active relapsing-remitting multiple sclerosis (RRMS). It is generally recommended for individuals who have not responded to a currently available first-line disease-modifying therapy or who have very active disease. The expected benefits of natalizumab treatment have to be weighed against risks, especially the rare but serious adverse event of progressive multifocal leukoencephalopathy. In this Review, we revisit and update previous recommendations on natalizumab for treatment of patients with RRMS, based on additional long-term follow-up of clinical studies and post-marketing observations, including appropriate patient selection and management recommendations.

• Authors: Ludwig Kappos, David Bates, Gilles Edan, Mefkûre Eraksoy, Antonio Garcia-Merino, Nikolaos Grigoriadis, Hans-Peter Hartung, Eva Havrdová, Jan Hillert, Reinhard Hohlfeld, Marcelo Kremenchutzky, Olivier Lyon-Caen, Ariel Miller, Carlo Pozzilli, Mads Ravnborg, Takahiko Saida, Christian Sindic, Karl Vass, David B Clifford, Stephen Hauser, Eugene O Major, Paul W O'Connor, Howard L Weiner, Michel Clanet, Ralf Gold, Hans H Hirsch, Ernst-Wilhelm Radü, Per Soelberg Sørensen, John King
• Journal: The Lancet. Neurology (Lancet Neurol) Vol. 10 Issue 8 Pg. 745-58 (Aug 2011) ISSN: 1474-4465 [Electronic] England
• PMID: 21777829 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)
• Copyright: Copyright © 2011 Elsevier Ltd. All rights reserved.

Chemical References

• Antibodies, Monoclonal
• Antibodies, Monoclonal, Humanized
• Integrin alpha4beta1
• Natalizumab

Topics

• Animals
• Antibodies, Monoclonal (adverse effects, therapeutic use)
• Antibodies, Monoclonal, Humanized
• Drug Monitoring (methods, standards)
• Humans
• Integrin alpha4beta1 (antagonists & inhibitors)
• Leukoencephalopathy, Progressive Multifocal (chemically induced, diagnosis)
• Multiple Sclerosis, Relapsing-Remitting (drug therapy)
• Natalizumab
• Patient Selection
• Practice Guidelines as Topic (standards)
• Treatment Outcome