Evolution of nevi during treatment with natalizumab: A prospective follow-up of patients treated with natalizumab for multiple sclerosis.
BACKGROUND
Natalizumab is a monoclonal antibody directed against α₄ integrin used in the treatment of multiple sclerosis (MS). Four cases of melanomas occurring in patients prescribed natalizumab to treat MS were recently reported. Although some fundamental data suggested that α₄β1 integrin could be linked to the invasiveness of melanoma, none showed any relation with the transformation of melanocytes.


METHODS
We performed a prospective follow-up of a cohort of patients with MS treated with natalizumab to assess the evolution of nevi under treatment. Clinical dermatologic examination and videodermoscopy were performed every 6 months. Nevi were compared side-by-side with baseline photographs, and histologic analysis was proposed based on clinical and dermoscopic criteria. Forty-four patients were included, and 248 nevi were examined and followed up. The mean duration of follow-up was 14 months (range, 6-20 months). Seventeen lesions (6.8%) showed modifications over time. Only 12 (4.8%) presented substantial dermoscopic changes. Five lesions were removed. All of them were classified as benign after histologic examination.


CONCLUSIONS
Our results showed the same rate of clinical and dermoscopic changes of nevi during treatment with natalizumab compared with the spontaneous evolution of nevi reported in literature. In accordance with fundamental data, those results suggest that the inhibition of the α₄ integrin does not promote the transformation of melanocytic lesions.
Castela
Emeline
E
Department of Dermatology, University Hospital of Nice, France.
Lebrun-Frenay
Christine
C
Laffon
Muriel
M
Rocher
Fanny
F
Cohen
Michael
M
Leccia
Nathalie Cardot
NC
Bahadoran
Philippe
P
Lacour
Jean-Philippe
JP
Ortonne
Jean-Paul
JP
Passeron
Thierry
T
D000293:Adolescent; D000328:Adult; D000911:Antibodies, Monoclonal / Q000009:adverse effects* / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D046169:Dermoscopy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D039441:Integrin alpha4 / Q000276:immunology*; D008297:Male; D008544:Melanocytes / Q000378:metabolism; D008545:Melanoma / Q000453:epidemiology / Q000209:etiology; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000188:drug therapy*; D000069442:Natalizumab; D009508:Nevus, Pigmented / Q000473:pathology*; D010781:Photography; D011446:Prospective Studies; D012878:Skin Neoplasms / Q000453:epidemiology / Q000209:etiology; D013997:Time Factors; D055815:Young Adult
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000069442:Natalizumab; D039441:Integrin alpha4