Clinical outcome of Natalizumab in patients with Multiple sclerosis

Abstract

Natalizumab is a monoclonal antibody that acts as an α4 integrin antagonist to prevent leukocyte trafficking into the central nervous system. 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). Material and Method: Clinical outcome of 22 patients with RRMS, who were failed to first line DMTs (Interferon beta, Glatiramer acetate) were estimated by using EDSS, before and after 24 months natalizumab treatment. Results: 16 women and 6 men interned in this study. There was no significant different in mean EDSS, before and after 24 months of natalizumab treatment (5.15± 0.8 vs 5.31±0.74, P=0.502). Annual relapse rate (ARR) in first and second year of natalizumab therapy were significantly lower than one year prior to starting the treatment. No PML or other serious adverse effects were seen in this study.