The use of natalizumab for multiple sclerosis
Rachel Brandstadter, Ilana Katz Sand Department of Neurology, Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Icahn School of Medicine at Mount Sinai, New York, NY, USA Abstract: Natalizumab is a monoclonal antibody that acts as an α4 integrin antagonist to prevent leukocyte t...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2017-06-01
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| Series: | Neuropsychiatric Disease and Treatment |
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| Online Access: | https://www.dovepress.com/the-use-of-natalizumab-for-multiple-sclerosis-peer-reviewed-article-NDT |
| _version_ | 1818695467935989760 |
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| author | Brandstadter R Katz Sand I |
| author_facet | Brandstadter R Katz Sand I |
| author_sort | Brandstadter R |
| collection | DOAJ |
| description | Rachel Brandstadter, Ilana Katz Sand Department of Neurology, Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Icahn School of Medicine at Mount Sinai, New York, NY, USA Abstract: Natalizumab is a monoclonal antibody that acts as an α4 integrin antagonist to prevent leukocyte trafficking into the central nervous system. It is US Food and Drug Administration (FDA) approved for the treatment of relapsing–remitting multiple sclerosis (RRMS). Natalizumab demonstrated high efficacy in Phase III trials by reducing the annualized relapse rate, preventing multiple sclerosis (MS) lesion accumulation on magnetic resonance imaging, and decreasing the probability of sustained progression of disability. The leading safety concern with natalizumab is its association with progressive multifocal leukoencephalopathy (PML), a rare brain infection typically seen only in severely immunocompromised patients caused by reactivation of the John Cunningham virus (JCV). Careful analysis of risk factors for PML in natalizumab-treated MS patients, specifically the presence of anti-JCV antibodies, has led to risk mitigation strategies to improve safety. Additional biomarkers are under investigation to further aid risk stratification. Natalizumab’s high efficacy and favorable tolerability profile have led to a broad use by MS physicians, as both first- and second-line treatments. This review discusses the natalizumab efficacy, safety, and tolerability and finishes with pragmatic considerations regarding its use in clinical practice. Keywords: review, efficacy, safety, progressive multifocal leukoencephalopathy, JC virus, treatment |
| first_indexed | 2024-12-17T13:45:57Z |
| format | Article |
| id | doaj.art-57556eede1514bf2982d42266f37def7 |
| institution | Directory Open Access Journal |
| issn | 1178-2021 |
| language | English |
| last_indexed | 2024-12-17T13:45:57Z |
| publishDate | 2017-06-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Neuropsychiatric Disease and Treatment |
| spelling | doaj.art-57556eede1514bf2982d42266f37def72022-12-21T21:46:09ZengDove Medical PressNeuropsychiatric Disease and Treatment1178-20212017-06-01Volume 131691170233492The use of natalizumab for multiple sclerosisBrandstadter RKatz Sand IRachel Brandstadter, Ilana Katz Sand Department of Neurology, Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Icahn School of Medicine at Mount Sinai, New York, NY, USA Abstract: Natalizumab is a monoclonal antibody that acts as an α4 integrin antagonist to prevent leukocyte trafficking into the central nervous system. It is US Food and Drug Administration (FDA) approved for the treatment of relapsing–remitting multiple sclerosis (RRMS). Natalizumab demonstrated high efficacy in Phase III trials by reducing the annualized relapse rate, preventing multiple sclerosis (MS) lesion accumulation on magnetic resonance imaging, and decreasing the probability of sustained progression of disability. The leading safety concern with natalizumab is its association with progressive multifocal leukoencephalopathy (PML), a rare brain infection typically seen only in severely immunocompromised patients caused by reactivation of the John Cunningham virus (JCV). Careful analysis of risk factors for PML in natalizumab-treated MS patients, specifically the presence of anti-JCV antibodies, has led to risk mitigation strategies to improve safety. Additional biomarkers are under investigation to further aid risk stratification. Natalizumab’s high efficacy and favorable tolerability profile have led to a broad use by MS physicians, as both first- and second-line treatments. This review discusses the natalizumab efficacy, safety, and tolerability and finishes with pragmatic considerations regarding its use in clinical practice. Keywords: review, efficacy, safety, progressive multifocal leukoencephalopathy, JC virus, treatmenthttps://www.dovepress.com/the-use-of-natalizumab-for-multiple-sclerosis-peer-reviewed-article-NDTNatalizumab Multiple Sclerosis Review Efficacy Safety Progressive multifocal leukoencephalopathy |
| spellingShingle | Brandstadter R Katz Sand I The use of natalizumab for multiple sclerosis Neuropsychiatric Disease and Treatment Natalizumab Multiple Sclerosis Review Efficacy Safety Progressive multifocal leukoencephalopathy |
| title | The use of natalizumab for multiple sclerosis |
| title_full | The use of natalizumab for multiple sclerosis |
| title_fullStr | The use of natalizumab for multiple sclerosis |
| title_full_unstemmed | The use of natalizumab for multiple sclerosis |
| title_short | The use of natalizumab for multiple sclerosis |
| title_sort | use of natalizumab for multiple sclerosis |
| topic | Natalizumab Multiple Sclerosis Review Efficacy Safety Progressive multifocal leukoencephalopathy |
| url | https://www.dovepress.com/the-use-of-natalizumab-for-multiple-sclerosis-peer-reviewed-article-NDT |
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