title: Natalizumab treatment for multiple sclerosis: updated recommendations for patient selection and monitoring.
abstract: Natalizumab, a highly specific α4-integrin antagonist, is approved for treatment of patients with active relapsing-remitting multiple sclerosis (RRMS). It is generally recommended for individuals who have not responded to a currently available first-line disease-modifying therapy or who have very active disease. The expected benefits of natalizumab treatment have to be weighed against risks, especially the rare but serious adverse event of progressive multifocal leukoencephalopathy. In this Review, we revisit 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.
authors.affiliation: University Hospital, Basel, Switzerland. lkappos@uhbs.ch
authors.forename: Ludwig
authors.initials: L
authors.lastname: Kappos
authors.forename: David
authors.initials: D
authors.lastname: Bates
authors.forename: Gilles
authors.initials: G
authors.lastname: Edan
authors.forename: Mefkûre
authors.initials: M
authors.lastname: Eraksoy
authors.forename: Antonio
authors.initials: A
authors.lastname: Garcia-Merino
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Grigoriadis
authors.forename: Hans-Peter
authors.initials: HP
authors.lastname: Hartung
authors.forename: Eva
authors.initials: E
authors.lastname: Havrdová
authors.forename: Jan
authors.initials: J
authors.lastname: Hillert
authors.forename: Reinhard
authors.initials: R
authors.lastname: Hohlfeld
authors.forename: Marcelo
authors.initials: M
authors.lastname: Kremenchutzky
authors.forename: Olivier
authors.initials: O
authors.lastname: Lyon-Caen
authors.forename: Ariel
authors.initials: A
authors.lastname: Miller
authors.forename: Carlo
authors.initials: C
authors.lastname: Pozzilli
authors.forename: Mads
authors.initials: M
authors.lastname: Ravnborg
authors.forename: Takahiko
authors.initials: T
authors.lastname: Saida
authors.forename: Christian
authors.initials: C
authors.lastname: Sindic
authors.forename: Karl
authors.initials: K
authors.lastname: Vass
authors.forename: David B
authors.initials: DB
authors.lastname: Clifford
authors.forename: Stephen
authors.initials: S
authors.lastname: Hauser
authors.forename: Eugene O
authors.initials: EO
authors.lastname: Major
authors.forename: Paul W
authors.initials: PW
authors.lastname: O'Connor
authors.forename: Howard L
authors.initials: HL
authors.lastname: Weiner
authors.forename: Michel
authors.initials: M
authors.lastname: Clanet
authors.forename: Ralf
authors.initials: R
authors.lastname: Gold
authors.forename: Hans H
authors.initials: HH
authors.lastname: Hirsch
authors.forename: Ernst-Wilhelm
authors.initials: EW
authors.lastname: Radü
authors.forename: Per Soelberg
authors.initials: PS
authors.lastname: Sørensen
authors.forename: John
authors.initials: J
authors.lastname: King
mesh_terms: D000818:Animals; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D016903:Drug Monitoring / Q000379:methods / Q000592:standards*; D006801:Humans; D039041:Integrin alpha4beta1 / Q000037:antagonists & inhibitors; D007968:Leukoencephalopathy, Progressive Multifocal / Q000139:chemically induced / Q000175:diagnosis; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000188:drug therapy*; D000069442:Natalizumab; D018579:Patient Selection; D017410:Practice Guidelines as Topic / Q000592:standards*; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D039041:Integrin alpha4beta1; D000069442:Natalizumab