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

@article{Kappos2007NatalizumabTF,
  title={Natalizumab treatment for multiple sclerosis: recommendations for patient selection and monitoring},
  author={Ludwig Kappos and David W. Bates and H. P. Hartung and Eva Kubala Havrdov{\'a} and David Miller and Chris H. Polman and Mads Henrik Ravnborg and Stephen L. Hauser and Richard A. Rudick and Howard L. Weiner and P. W. O'Connor and John O King and Ernst-Wilhelm Radue and Tarek A. Yousry and Eugene O. Major and David B. Clifford},
  journal={The Lancet Neurology},
  year={2007},
  volume={6},
  pages={431-441}
}
Natalizumab is a new treatment option for patients with active relapsing-remitting multiple sclerosis. In phase III studies, natalizumab was highly effective and well tolerated; however, three cases of progressive multifocal leucoencephalopathy (PML) were identified (estimated incidence of one per 1000; 95% CI 0.2-2.8; mean treatment period 17.9 months). In this Review we summarise the current information on PML, the three confirmed cases of PML, and the results of an extensive safety… 
A review of the evidence for a natalizumab exit strategy for patients with multiple sclerosis.
TLDR
The evidence suggests that the washout period between natalizumab and fingolimod should not exceed 12 weeks, and the limited evidence available for rituximab and alemtuzumab is promising, and further data on these and other newer therapies for RRMS are awaited.
Natalizumab for multiple sclerosis: a complicated treatment
TLDR
In their updated Review, Kappos and colleagues indicate that natalizumab-treated patients with MS are at higher risk of PML than previously thought, particularly if duration of exposure to the drug is 25–48 months and if the individual received immunosuppressive drugs before treatment with natalIZumab.
Natalizumab treatment for multiple sclerosis: updated recommendations for patient selection and monitoring
TLDR
This Review revisits 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.
Best practice in the use of natalizumab in multiple sclerosis
  • O. Fernández
  • Medicine
    Therapeutic advances in neurological disorders
  • 2013
TLDR
The recent availability of a two-step enzyme-linked immunosorbent assay (ELISA) test for the presence of anti-JCV antibodies, along with an ever-improving understanding of other risk factors, allow an increasingly refined stratification of the risk of PML.
Successful management of natalizumab-associated progressive multifocal leukoencephalopathy and immune reconstitution syndrome in a patient with multiple sclerosis.
TLDR
In the setting of early diagnosis and consequent treatment, natalizumab-associated PML can be well managed in some cases, which differs from the course of PML in other conditions, eg, after the application of depleting monoclonal antibodies.
Review: Natalizumab in the treatment of multiple sclerosis
Natalizumab reduced the rate of clinical relapse at one year by 68% and the risk of sustained progression of disability by 42—54% over 2 years in its pivotal phase III trial (AFFIRM) in
Use of Natalizumab in Patients with Multiple Sclerosis: 2015 Update
TLDR
The purpose of this article is to revise and add to the previous publications to reflect the latest available knowledge on the use of natalizumab, including long-term efficacy and real-world safety data with natalIZumab in MS, appropriate monitoring strategies for treated patients, and use of the anti-JCV antibody index in risk stratification for natalizzumabassociated PML.
Spanish consensus on the use of natalizumab (Tysabri®)-2013.
TLDR
This update provides general recommendations, but neurologists must use their clinical expertise to provide personalised follow-up for each patient, as the drug is very effective, but its potential adverse effects need to be considered.
Natalizumab treatment in pediatric multiple sclerosis: a case report.
TLDR
A 12-year-old girl with MS, recently approved as a monotherapy for patients with MS who experienced inadequate response to other disease modifying therapies, shows a complete response to Natalizumab with clinical and MRI suppression of disease activity.
Spanish consensus on the use of natalizumab (Tysabri(®))--2011.
TLDR
A consensus is established that establishes general recommendations, but neurologists must use their clinical expertise to monitor patients individually in order to improve the management of natalizumab-treated patients.
...
1
2
3
4
5
...

References

SHOWING 1-10 OF 88 REFERENCES
Natalizumab: Immune effects and implications for therapy
TLDR
Two articles in this issue of Annals provide the first detailed look at immunological effects of natalizumab treatment in patients with MS, and demonstrate that treatment dramatically reduces the number of cerebrospinal fluid mononuclear cells.
Natalizumab plus interferon beta-1a for relapsing multiple sclerosis.
TLDR
Natalizumab added to interferon beta-1a was significantly more effective in patients with relapsing multiple sclerosis, and additional research is needed to elucidate the benefits and risks of this combination treatment.
A randomized, placebo-controlled trial of natalizumab for relapsing multiple sclerosis.
TLDR
Natalizumab reduced the risk of the sustained progression of disability and the rate of clinical relapse in patients with relapsing multiple sclerosis and hold promise as an effective treatment for relapsed multiple sclerosis.
Progressive multifocal leucoencephalopathy and immunosuppression.
We report an immunocompromised patient with progressive multifocal leucoencephalopathy (PML), who demonstrates the usefulness and limitation of the algorithm of Warnatz et al 1 for investigation of
Progressive Multifocal Leukoencephalopathy in AIDS: Are There Any MR Findings Useful to Patient Management and Predictive of Patient Survival?
TLDR
No MR findings predictive of the risk of death in patients with PML were found, with the exception of mass effect, which was significantly associated with shorter survival and was not a useful MR prognostic sign.
Progressive multifocal leukoencephalopathy in patients with HIV infection.
TLDR
Progressive multifocal leukoencephalopathy often heralds AIDS and may occur in the absence of significant decline in CD4 lymphocytes, and survival is generally poor, although prolonged survival beyond 1 year is not unusual.
Progressive multifocal leukoencephalopathy in transplant recipients
TLDR
Progressive multifocal leukoencephalopathy is a unique entity that should be considered in any transplant recipient with neurological symptoms and is usually fatal, although regression has been reported.
Intramuscular interferon beta‐1a for disease progression in relapsing multiple sclerosis
TLDR
Interferon beta‐ la had a significant beneficial impact in relapsing multiple sclerosis patients by reducing the accumulation of permanent physical disability, exacerbation frequency, and disease activity measured by gadolinium‐enhanced lesions on brain magnetic resonance images.
New insights into progressive multifocal leukoencephalopathy
TLDR
Advances in the understanding of JC virus biology have shed new light on the pathogenesis of progressive multifocal leukoencephalopathy, and on its possible role in cerebellar atrophy in HIV-infected individuals.
Opportunistic Infections of the CNS in Patients with AIDS
TLDR
Effective treatments are available for toxoplasmosis and cryptococcosis, although adverse effects are common and some patients may not respond to therapy, and the efficacy of anticytomegalovirus therapy is poor and the toxicity significant.
...
1
2
3
4
5
...