Natalizumab in multiple sclerosis: discontinuation, progressive multifocal leukoencephalopathy and possible use in children

Authors

Giovanna Vitaliti, General Paediatrics Operative Unit , Policlinico-Vittorio-Emanuele University Hospital, University of Catania , Catania , Italy.
Nassim Matin, Tehran University of Medical Sciences , Tehran , Iran.
Omidreza Tabatabaie, Tehran University of Medical Sciences , Tehran , Iran.
Mario Di Traglia, Department of Statistics , La Sapienza University of Rome , Rome , Italy.
Piero Pavone, General Paediatrics Operative Unit , Policlinico-Vittorio-Emanuele University Hospital, University of Catania , Catania , Italy.
Riccardo Lubrano, Paediatric Department, Paediatric Nephrology Operative Unit , Sapienza University of Rome , Rome , Italy.
Raffaele Falsaperla, General Paediatrics Operative Unit , Policlinico-Vittorio-Emanuele University Hospital, University of Catania , Catania , Italy.

Document Type

Article

Abstract

In the early 1990s, attention was drawn to the migration of immune cells into the central nervous system via the blood-brain barrier. The literature showed that lymphocytes binding to the endothelium were successfully inhibited by an antibody against α4β1 integrin. These biological findings resulted in the development of a humanized antibody to α4 integrin - natalizumab (NTZ) - to treat multiple sclerosis (MS). Here, we provide a systematic review and meta-analysis on the efficacy and safety of natalizumab, trying to answer the question whether its use may be recommended both in adult and in pediatric age groups as standard MS treatment. Our results highlight the improvement of clinical and radiological findings in treated patients (p < 0.005), confirming NTZ efficacy. Nevertheless, if NTZ is shown to be efficient, further studies should be performed to evaluate its safety and to target the MS profile that could benefit from this treatment.

Medical Subject Headings

Antibodies, Monoclonal, Humanized (administration & dosage, therapeutic use); Child; Clinical Protocols; Humans; Leukoencephalopathy, Progressive Multifocal (drug therapy); Multiple Sclerosis (drug therapy); Natalizumab (administration & dosage, therapeutic use)

Publication Date

1-1-2015

Publication Title

Expert review of neurotherapeutics

E-ISSN

1744-8360

Volume

15

Issue

11

First Page

1321

Last Page

41

PubMed ID

26513633

Digital Object Identifier (DOI)

10.1586/14737175.2015.1102061

Recommended Citation

Vitaliti, Giovanna; Matin, Nassim; Tabatabaie, Omidreza; Di Traglia, Mario; Pavone, Piero; Lubrano, Riccardo; and Falsaperla, Raffaele, "Natalizumab in multiple sclerosis: discontinuation, progressive multifocal leukoencephalopathy and possible use in children" (2015). Neurology. 1511.
https://scholar.barrowneuro.org/neurology/1511