Natalizumab reduces clinical and MRI activity in multiple sclerosis patients with high disease activity: results from a multicenter study in Switzerland

Eur Neurol. 2010;63(2):101-6. doi: 10.1159/000276400. Epub 2010 Jan 16.


Background: Natalizumab has been recommended for the treatment of relapsing-remitting multiple sclerosis (RRMS) in patients with insufficient response to interferon-beta or glatiramer acetate (disease-modifying treatments-DMT) or in aggressive MS. The pivotal trials were not designed to investigate natalizumab monotherapy in these patient populations.

Aim: To investigate the efficacy of natalizumab after treatment failure of previous DMT and in highly active MS.

Methods: A retrospective, multicenter study in Switzerland. Three major MS centers reported all RRMS patients who initiated natalizumab>or=12 months prior to study conduction.

Results: 85 RRMS patients were included (72% female, mean age 37.3 years, mean Expanded Disability Status Scale 3.1; 88.2% were pretreated with DMT), and mean treatment duration with natalizumab was 18.4+/-2.6 months. 79% of the patients were relapse-free during the observational period. The annualized relapse rate decreased from 2.0+/-0.6 to 0.27+/-0.2, and 92.9% were progression-free after 12 months (p<0.001). The mean number of gadolinium-enhancing lesions decreased from 1.2+/-1.2 to 0.1+/-0.1 at 12 months' follow-up (91.7% reduction).Discontinuation rate was 11.8% (7.1% for antibody positivity).

Conclusions: Patients who initiate natalizumab after previous high disease activity experience a marked reduction of clinical and MRI disease activity.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antibodies, Monoclonal / therapeutic use*
  • Antibodies, Monoclonal, Humanized
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Multiple Sclerosis, Relapsing-Remitting / drug therapy*
  • Natalizumab
  • Retrospective Studies
  • Switzerland


  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Natalizumab