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Early relapses after the first dose of natalizumab in active multiple sclerosis patients

¹ Department of Neuroscience, Neurologic Clinics, Tor Vergata University, Rome, Italy; European Center for Brain Research (CERC)/Fondazione Santa Lucia, Rome, Italy
² Neuroimmunology Unit, Institute of Experimental Neurology (INSpe), San Raffaele Scientific Institute, Milan, Italy
³ Department of Neurosciences, San Camillo Hospital, Rome, Italy
⁴ Neurologic Clinics, Center for Experimental Neurological Therapy, La Sapienza University, Rome, Italy
⁵ European Center for Brain Research (CERC)/Fondazione Santa Lucia, Rome, Italy

^* To whom correspondence should be addressed.

	Abstract

Background

Natalizumab is prescribed in Italy in patients who experienced at least two clinical relapses during a 12-month therapy with other approved immunomodulatory agents.

Results

In 7 of 35 patients selected on the basis of these recommendations, we have observed clinical relapses occurring within 24 h after the first dose of natalizumab.

Conclusion

The mechanism by which a first injection of natalizumab may precipitate a clinical relapse in patients with MS is unknown. We speculate that natalizumab can promote the release of inflammatory mediators from lymphocytes present in the central nervous system at the time of the first infusion, thus favoring the clinical manifestation of a pre-existing active lesion.

Key Words: monoclonal antibody, VLA-4, tysabri

First published on August 13, 2008, doi:10.1177/1352458508092810

Multiple Sclerosis 2008;14:1137.

A more recent version of this article appeared on September 1, 2008


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This article has been cited by other articles:

				F. Rinaldi, P. Perini, M. Calabrese, L. Rinaldi, and P. Gallo Severe relapses after the first infusion of natalizumab in active relapsing--remitting multiple sclerosis Multiple Sclerosis, November 1, 2009; 15(11): 1359 - 1362. [Abstract] [PDF]

				J Haartsen, M Marriott, and H Butzkueven Re: Early relapses after the first dose of natalizumab in active multiple sclerosis Multiple Sclerosis, April 1, 2009; 15(4): 520 - 520. [PDF]