Natalizumab drug holiday in multiple sclerosis: poorly tolerated

Ann Neurol. 2010 Sep;68(3):392-5. doi: 10.1002/ana.22074.


It has been suggested that natalizumab-associated progressive multifocal leukoencephalopathy may be prevented by structured interruptions of treatment. Evidence supporting such a drug holiday is not yet available. Here we present initial observations in 10 multiple sclerosis patients who were stringently monitored up to 6 months after discontinuation of the infusions. Cumulatively, a combination of clinical relapse and new and/or enhanced lesions on magnetic resonance imaging had occurred in 7 of 10 patients. Although numbers are small, our data suggest that in patients who were switched to natalizumab because of disease activity despite first-line treatment, a natalizumab drug holiday without reinstatement of alternate disease-modifying therapy is poorly tolerated.

MeSH terms

  • Adult
  • Antibodies, Monoclonal / therapeutic use*
  • Antibodies, Monoclonal, Humanized
  • Female
  • Follow-Up Studies
  • Humans
  • Integrin alpha4 / immunology*
  • Magnetic Resonance Imaging / methods
  • Male
  • Middle Aged
  • Multiple Sclerosis / drug therapy*
  • Natalizumab
  • Recurrence


  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Natalizumab
  • Integrin alpha4