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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Autores principales:	Brandstadter R, Katz Sand I
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2017
Materias:	Natalizumab Multiple Sclerosis Review Efficacy Safety Progressive multifocal leukoencephalopathy Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/57556eede1514bf2982d42266f37def7
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spelling	oai:doaj.org-article:57556eede1514bf2982d42266f37def72021-12-02T02:44:19ZThe use of natalizumab for multiple sclerosis1178-2021https://doaj.org/article/57556eede1514bf2982d42266f37def72017-06-01T00:00:00Zhttps://www.dovepress.com/the-use-of-natalizumab-for-multiple-sclerosis-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Rachel 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, treatmentBrandstadter RKatz Sand IDove Medical PressarticleNatalizumab Multiple Sclerosis Review Efficacy Safety Progressive multifocal leukoencephalopathyNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 13, Pp 1691-1702 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Natalizumab Multiple Sclerosis Review Efficacy Safety Progressive multifocal leukoencephalopathy Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	Natalizumab Multiple Sclerosis Review Efficacy Safety Progressive multifocal leukoencephalopathy Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Brandstadter R Katz Sand I The use of natalizumab for multiple sclerosis
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
format	article
author	Brandstadter R Katz Sand I
author_facet	Brandstadter R Katz Sand I
author_sort	Brandstadter R
title	The use of natalizumab for multiple sclerosis
title_short	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_sort	use of natalizumab for multiple sclerosis
publisher	Dove Medical Press
publishDate	2017
url	https://doaj.org/article/57556eede1514bf2982d42266f37def7
work_keys_str_mv	AT brandstadterr theuseofnatalizumabformultiplesclerosis AT katzsandi theuseofnatalizumabformultiplesclerosis AT brandstadterr useofnatalizumabformultiplesclerosis AT katzsandi useofnatalizumabformultiplesclerosis
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The use of natalizumab for multiple sclerosis

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