Natalizumab

K K Jain MD (Dr. Jain is a consultant in neurology and has no relevant financial relationships to disclose.)
Originally released January 17, 2003; last updated January 13, 2017; expires January 13, 2020

Historical note and terminology

Natalizumab, a humanized monoclonal antibody, is an alpha4 integrin antagonist that has been shown to reduce the development of brain lesions in experimental models as well as in patients with multiple sclerosis in clinical trials. Integrins are adhesion molecules that stabilize the interaction between cells and their environments by cell signaling. Early evidence for alpha4 integrin-mediated central nervous system disease was based on study of autoimmune encephalomyelitis, a T cell–mediated disease that resembles multiple sclerosis in animals (Yednock et al 1992). In 2004, the FDA approved natalizumab and it is marketed under the trade name of “Tysabri” (Biogen Idec and Elan). In 2005, it was temporarily withdrawn from the market because of a link with cases of progressive multifocal leukoencephalopathy, but it was restored to the market in 2006 as the benefit was shown to be greater than the risk of adverse effects.

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