Natalizumab treatment for multiple sclerosis: Updated recommendations for patient selection and monitoring

Ludwig Kappos, David Bates, Gilles Edan, Mefkûre Eraksoy, Antonio Garcia-Merino, Nikolaos Grigoriadis, Hans Peter Hartung, Eva Havrdová, Jan Hillert, Reinhard Hohlfeld, Marcelo Kremenchutzky, Olivier Lyon-Caen, Ariel Miller, Carlo Pozzilli, Mads Ravnborg, Takahiko Saida, Christian Sindic, Karl Vass, David B. Clifford, Stephen HauserEugene O. Major, Paul W. O'Connor, Howard L. Weiner, Michel Clanet, Ralf Gold, Hans H. Hirsch, Ernst Wilhelm Radü, Per Soelberg Sørensen, John King

Research output: Contribution to journalReview articlepeer-review

245 Scopus citations


Natalizumab, a highly specific α4-integrin antagonist, is approved for treatment of patients with active relapsing-remitting multiple sclerosis (RRMS). It is generally recommended for individuals who have not responded to a currently available first-line disease-modifying therapy or who have very active disease. The expected benefits of natalizumab treatment have to be weighed against risks, especially the rare but serious adverse event of progressive multifocal leukoencephalopathy. In this Review, we revisit and update previous recommendations on natalizumab for treatment of patients with RRMS, based on additional long-term follow-up of clinical studies and post-marketing observations, including appropriate patient selection and management recommendations.

Original languageEnglish
Pages (from-to)745-758
Number of pages14
JournalThe Lancet Neurology
Issue number8
StatePublished - Aug 2011


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