title: The efficacy and safety of natalizumab for the treatment of multiple sclerosis in Portugal: a retrospective study.
abstract: BACKGROUND
  Studies have shown that natalizumab is an effective treatment for relapsing-remitting multiple sclerosis (RRMS). To date, no data are available in Portuguese patients.
  
  
  OBJECTIVE
  To determine the efficacy and safety of natalizumab in patients with RRMS in routine clinical practice in Portugal.
  
  
  METHODS
  Clinical data for adult patients with RRMS treated with natalizumab at specialist neurology centres in Portugal were entered retrospectively into a database for analysis between October 2010 and February 2012. Changes in annualized relapse rates (ARR), Expanded Disability Status Scale (EDSS) scores and disability status were analysed.
  
  
  RESULTS
  A total of 383 patients from 20 centres were included. Prior to starting natalizumab, the baseline median EDSS score was 4 and the mean ARR was 1.64. Most patients had previously received multiple sclerosis treatment (93.0%). Median natalizumab treatment duration was 12 months. Natalizumab treatment was associated with significant (p < 0.001) reductions from baseline in the mean ARR and EDSS scores in patients treated with natalizumab for >= 12 months (n = 288) and for >= 24 months (n = 160). Natalizumab was more effective in patients with less disability (EDSS < 3) and in those who had not previously received disease-modifying treatments. Two cases of progressive multifocal leukoencephalopathy were reported. No new unexpected adverse events occurred.
  
  
  CONCLUSIONS
  Natalizumab is well tolerated, and is effective in reducing relapse rate and stabilising disease in patients with RRMS in the clinical practice setting in Portugal. Its efficacy persists with continued treatment, and it may be particularly effective in patients with less disability and without prior disease modifying therapy.
authors.affiliation: Centro Hospitalar e Universitario de Coimbra, Hospitais da Universidade de Coimbra, Coimbra, Portugal.
authors.forename: L
authors.initials: L
authors.lastname: Sousa
authors.forename: J
authors.initials: J
authors.lastname: de Sa
authors.forename: M J
authors.initials: MJ
authors.lastname: Sa
authors.forename: J J
authors.initials: JJ
authors.lastname: Cerqueira
authors.forename: A
authors.initials: A
authors.lastname: Martins-Silva
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects / Q000627:therapeutic use*; D004185:Disability Evaluation; D004342:Drug Hypersensitivity / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D007239:Infections / Q000453:epidemiology; D007968:Leukoencephalopathy, Progressive Multifocal / Q000453:epidemiology / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000188:drug therapy* / Q000453:epidemiology; D009203:Myocardial Infarction / Q000139:chemically induced / Q000453:epidemiology; D000069442:Natalizumab; D011174:Portugal / Q000453:epidemiology; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000069442:Natalizumab