Thursday, 20 June 2013

Neutralising antibodies to natalizumab

Antibodies to natalizumab may be commoner than previously reported. #MSBlog #MSResearch

Epub: Oliver-Martos et al. Early development of anti-natalizumab antibodies in MS patients. J Neurol. 2013 Jun.

Objectives: The purpose of this study is to monitor the development of anti-natalizumab antibodies to evaluate their first appearance in MSers, since their presence has been associated with a reduction in the efficacy of the treatment and an increase of adverse events. 

Methods: A total of 134 MSers were included in the trial. Anti-natalizumab antibodies were monthly detected by ELISA up to the first year of treatment and subsequently, a determination was made at 18 months. 

Results: 15.7 % of the MSers were positive, being 7.5 % transiently positive and 8.2 % persistently positive. The first appearance of anti-natalizumab antibodies occurred after the first month of treatment onset in 72 % of positive MSers; 18 % did so after the second month, and 9.7 % after the third month. Antibodies were never detected for the first time after the fourth infusion. The development of anti-natalizumab antibodies occurs very early after treatment onset. 

Conclusion: These observations should be considered when standardizing the follow up of MSers treated with this drug in order to minimize the risks and optimize the treatment.


"Neutralizing anti-natalizumab antibodies stop the drug working and are associated with infusion reactions. We have noticed that a lot of units don't test for them routinely; they should. Why give an expensive drug to someone with antibodies when the drug won't work? They also are strongly associated with infusion reactions."

2 comments:

  1. " Antibodies were never detected for the first time after the fourth infusion"

    Am I right to understand that no cases were reported after month 4 ?

    In other words, if it works on a patient for 3 month it should work until his/her's MS evolves into SPMS?

    ReplyDelete
  2. "Why give an expensive drug to someone with antibodies when the drug won't work?" Well said.
    Wonder whether you question the wisdom in taking interferon beta if antibodies have been detected in the serum?

    ReplyDelete

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