title: Long-term safety and efficacy of natalizumab in relapsing-remitting multiple sclerosis: impact on quality of life.
abstract: Natalizumab was the first monoclonal antibody to be approved for the treatment of relapsing-remitting multiple sclerosis (RRMS) based on its short-term efficacy and overall tolerability. However, the incidence of treatment-associated progressive multifocal leukoencephalopathy (PML), an infection of the brain caused by the John Cunningham virus, jeopardized this efficacious treatment from the beginning. Eight years after licensing of natalizumab, long-term studies confirm the considerable and sustained efficacy of natalizumab, although the PML complication still threatens one of the most successful treatments available for RRMS. During these years, considerable progress has been made in identification of risk factors that allow more effective management of PML risk. In addition, long-term studies to define better when to start or stop treatment and to optimize treatment strategies after cessation of natalizumab are ongoing, and hopefully will improve management and will allow natalizumab to remain as a valuable therapeutic option for patients with highly active RRMS.
authors.affiliation: Neuroimmunology and MS Research, Department of Neurology, University of Zurich, Zurich, Switzerland.
authors.forename: Raquel
authors.initials: R
authors.lastname: Planas
authors.affiliation: Neuroimmunology and MS Research, Department of Neurology, University of Zurich, Zurich, Switzerland.
authors.forename: Roland
authors.initials: R
authors.lastname: Martin
authors.affiliation: Neuroimmunology and MS Research, Department of Neurology, University of Zurich, Zurich, Switzerland.
authors.forename: Mireia
authors.initials: M
authors.lastname: Sospedra
keywords: multiple sclerosis; progressive multifocal leukoencephalopathy; therapy
references.citation: Ann Neurol. 2009 Sep;66(3):403-6
references.pmid: 19798640
references.citation: Arch Neurol. 2008 Dec;65(12):1596-603
references.pmid: 18852339
references.citation: Neurology. 2009 Mar 3;72(9):806-12
references.pmid: 19255407
references.citation: Ann Neurol. 2006 May;59(5):748-54
references.pmid: 16634035
references.citation: Acta Neuropathol. 2012 May;123(5):751-2
references.pmid: 22407011
references.citation: J Neurol Neurosurg Psychiatry. 2010 Mar;81(3):247-54
references.pmid: 19828476
references.citation: Neurol Sci. 2011 Feb;32(1):83-8
references.pmid: 20872033
references.citation: Neurology. 2009 Apr 28;72(17):1458-64
references.pmid: 19129505
references.citation: Patient. 2009 Jun 1;2(2):105-12
references.pmid: 22273086
references.citation: J Neurol. 2009 Oct;256(10):1771-2
references.pmid: 19609591
references.citation: Eur Neurol. 2010;63(2):101-6
references.pmid: 20090344
references.citation: Mult Scler. 2014 Jan;20(1):108-11
references.pmid: 23828867
references.citation: Mult Scler. 2012 Dec;18(12):1760-7
references.pmid: 22570359
references.citation: N Engl J Med. 2006 Mar 2;354(9):911-23
references.pmid: 16510745
references.citation: PLoS One. 2012;7(4):e35843
references.pmid: 22558238
references.citation: Ann Neurol. 2010 Sep;68(3):304-10
references.pmid: 20737514
references.citation: Neurol Sci. 2013 Apr;34(4):521-8
references.pmid: 22526763
references.citation: Brain. 2011 Sep;134(Pt 9):2687-702
references.pmid: 21908874
references.citation: Neurology. 2009 Oct 27;73(17):1346-7
references.pmid: 19776376
references.citation: Bone Marrow Transplant. 2010 Oct;45(10):1489-96
references.pmid: 20098455
references.citation: Ann Neurol. 2006 May;59(5):743-7
references.pmid: 16634029
references.citation: Neurology. 1996 Apr;46(4):907-11
references.pmid: 8780061
references.citation: N Engl J Med. 2005 Jul 28;353(4):362-8
references.pmid: 15947080
references.citation: N Engl J Med. 2005 Jul 28;353(4):369-74
references.pmid: 15947079
references.citation: Semin Neurol. 2013 Feb;33(1):26-36
references.pmid: 23709210
references.citation: N Engl J Med. 2006 Mar 2;354(9):924-33
references.pmid: 16510746
references.citation: Mult Scler. 2011 Feb;17(2):198-203
references.pmid: 21135021
references.citation: Ann Neurol. 2011 Jan;69(1):83-9
references.pmid: 21280078
references.citation: Neurology. 2011 May 31;76(22):1858-65
references.pmid: 21543733
references.citation: Neurology. 2008 Oct 21;71(17):1350-4
references.pmid: 18936427
references.citation: J Neurol Sci. 2008 Nov 15;274(1-2):39-41
references.pmid: 18474372
references.citation: Neurology. 2007 Apr 17;68(16):1299-304
references.pmid: 17438220
references.citation: Proc Natl Acad Sci U S A. 2009 Feb 10;106(6):1920-5
references.pmid: 19179279
references.citation: Acta Neurol Scand. 2013 Jul;128(1):e1-5
references.pmid: 23311457
references.citation: Mult Scler. 2012 Jun;18(6):909-11
references.pmid: 22048950
references.citation: Lancet Neurol. 2010 Apr;9(4):425-37
references.pmid: 20298966
references.citation: PLoS One. 2008 Apr 30;3(4):e2028
references.pmid: 18446218
references.citation: Acta Neuropathol. 2012 Feb;123(2):235-45
references.pmid: 22057786
references.citation: Ther Clin Risk Manag. 2013;9:361-9
references.pmid: 24124371
references.citation: Eur Neurol. 2010;63(5):311-7
references.pmid: 20453514
references.citation: Annu Rev Immunol. 2005;23:683-747
references.pmid: 15771584
references.citation: Brain. 2009 May;132(Pt 5):1175-89
references.pmid: 19339255
references.citation: N Engl J Med. 2006 Mar 2;354(9):899-910
references.pmid: 16510744
references.citation: Mult Scler. 2010 Dec;16(12):1507-12
references.pmid: 20826527
references.citation: Clin Infect Dis. 2013 Sep;57(6):849-52
references.pmid: 23728144
references.citation: Mult Scler. 2012 Jan;18(1):64-71
references.pmid: 21828195
references.citation: Lancet Neurol. 2010 Mar;9(3):264-72
references.pmid: 20117055
references.citation: Neurology. 2009 Oct 27;73(17):1418-9
references.pmid: 19776379
references.citation: Health Qual Life Outcomes. 2012 Dec 27;10:155
references.pmid: 23270428
references.citation: N Engl J Med. 2009 Sep 10;361(11):1067-74
references.pmid: 19741227
references.citation: N Engl J Med. 2008 Feb 7;358(6):647-8
references.pmid: 18256405
references.citation: Mult Scler. 2011 Jun;17(6):708-19
references.pmid: 21228027
references.citation: N Engl J Med. 2012 May 17;366(20):1870-80
references.pmid: 22591293
references.citation: Neurology. 2011 May 17;76(20):1697-704
references.pmid: 21576685
references.citation: N Engl J Med. 2005 Jul 28;353(4):375-81
references.pmid: 15947078
references.citation: BioDrugs. 2011 Oct 1;25(5):299-306
references.pmid: 21942914
references.citation: Eur J Neurol. 2011 Feb;18(2):240-245
references.pmid: 20561044
references.citation: Lancet Neurol. 2010 Apr;9(4):438-46
references.pmid: 20298967
references.citation: Blood. 2008 Apr 1;111(7):3439-41
references.pmid: 18195093
references.citation: Nature. 1992 Mar 5;356(6364):63-6
references.pmid: 1538783
references.citation: Arch Neurol. 2004 Oct;61(10):1523-7
references.pmid: 15477505
references.citation: Eur Neurol. 2012;67(3):162-6
references.pmid: 22269396
references.citation: J Neuroimmunol. 2011 Jun;235(1-2):70-6
references.pmid: 21550672
references.citation: Neurol Sci. 2011 Feb;32(1):181-2
references.pmid: 21052756
references.citation: Mult Scler. 2013 Apr;19(5):593-600
references.pmid: 22992450
references.citation: Blood. 2008 Apr 1;111(7):3893-5
references.pmid: 18235044
references.citation: CNS Drug Rev. 2007 Spring;13(1):79-95
references.pmid: 17461891
references.citation: Eur J Immunol. 2012 Mar;42(3):790-8
references.pmid: 22144343
references.citation: Neurol India. 2010 Jan-Feb;58(1):118-21
references.pmid: 20228479
references.citation: Drugs. 2013 Sep;73(13):1463-81
references.pmid: 23912625
references.citation: Annu Rev Med. 2010;61:35-47
references.pmid: 19719397
references.citation: Mult Scler. 2009 Dec;15(12):1532-3
references.pmid: 20019096
references.citation: Aliment Pharmacol Ther. 2010 May;31(9):1028-35
references.pmid: 20163378
references.citation: Ann Neurol. 2006 Aug;60(2):162-73
references.pmid: 16862584
references.citation: Neurology. 2013 Sep 3;81(10):865-71
references.pmid: 23925765
references.citation: Mult Scler. 2012 Feb;18(2):143-52
references.pmid: 22312009
references.citation: Eur J Neurol. 2009 Mar;16(3):420-3
references.pmid: 19364368
references.citation: Dig Liver Dis. 2012 Apr;44(4):356-7
references.pmid: 22154948
references.citation: PLoS One. 2013;8(3):e58643
references.pmid: 23555589