Efficacy & Safety of Natalizumab's Extended Interval Dosing in Relapsing Remitting Multiple Sclerosis

• Published in: Multiple sclerosis and related disorders 2023-12, Vol.80, p.105201, Article 105201
• Main Authors: Al-Mahdawi, Akram Mohammed, Hatem, Dr. Anmar Oday, Hussen, Dr Hussen Walaa
• Format: Article
• Language: English
• ISSN: 2211-0348
• DOI: 10.1016/j.msard.2023.105201

The monoclonal antibody, natalizumab (NTZ), interacts with the adhesion molecule 4-integrin on the surface of mononuclear cells, decreasing their traffic into the central nervous system (CNS). Recent studies support the idea that a prolonged dose interval could maintain natalizumab efficacy because partial saturation in the 70-80% range may be sufficient to avoid relapses and the development of new MRI lesions. This was an observational retrospective cohort study. Data was collected over a period of 1 year from August 2021 to August 2022, for all adult relapsing-remitting multiple sclerosis (RRMS) patients receiving natalizumab and who were admitted from emergency department or outpatient clinic for standard clinical practice at the medical city and neuroscience teaching hospitals. A total of 150 MS patients participated in the study. The majority of participants were females 99 (66%), the mean of age was 37.3 years, the duration since diagnosis of MS was 9.7 years. Seventy-five (50%) patients were on standard interval dosing (SID) and the other half were on extended interval dosing (EID). One hundred sixteen (77.3%) patients didn't complain of any relapses, and 21 (14%) had TI enhancing lesions. The T2 new lesions and T2 enlarging lesion were noted among 43 (28.7%) and 34 (22.7%) patients, respectively. Significant differences existed between the SID and EID in terms of age, duration of MS, and the Expanded Disability Status Scale (EDSS). Administration of natalizumab in an EID regimen maintains therapeutic efficacy in MS.