Tysabri inhibits the inflammation that leads to bladder problems

Khatri BO, Foley JF, Fink J, Kramer JF, Cha C, You X, Warth JD, Foulds P.The TRUST (EvaluaTion of Bladder Function in Relapsing-Remitting MUltiple Sclerosis Patients Treated with Natalizumab) Observational Study. Int J MS Care. 2014 Spring;16(1):40-7. doi: 10.7224/1537-2073.2013-003.

Background: Bladder dysfunction is a common symptom of multiple sclerosis (MS). This study was designed to evaluate effects of natalizumab on bladder function in patients with relapsing-remitting MS. Methods: The TRUST (EvaluaTion of Bladder Function in Relapsing-Remitting MUltiple Sclerosis Patients Treated with Natalizumab) study was an open-label, single-arm, two-center study. Natalizumab-naive MS patients with disabling bladder dysfunction and initiating natalizumab were enrolled and followed for 6 months. The primary endpoint was change in the Urogenital Distress Inventory short form (UDI-6) score from baseline. Change in Incontinence Impact Questionnaire short form (IIQ-7) score from baseline was a secondary endpoint. 
Results: Thirty patients were enrolled. Mean baseline characteristics were age 49.9 years, Expanded Disability Status Scale score 4.6, number of relapses in previous year 2.4, UDI-6 score 10.4, and IIQ-7 score 12.3. Mean changes in UDI-6 and IIQ-7 scores were significantly improved from baseline beginning at week 4 and up to week 24; mean improvements at 24 weeks were 4.4 (P < .0001) and 4.9 (P = .0005) points, respectively. At week 24, 85.7% and 78.6% of patients demonstrated improvements from baseline in UDI-6 and IIQ-7 scores, respectively. 
Conclusions: Incontinence-related quality of life as measured by UDI-6 and IIQ-7 scores improved significantly during natalizumab treatment.
This study says that if you treat an MSer with bladder problems with tysabri then some of the bladder problems may improve. I normally do not post these clinical posts and ProfG may have more to say but he has been very busy today. This does not surprise me because if the inflammation is driving some of the problems that lead to the bladder problems, then it stands to reason that it could affect many different symptoms as is is targeting the cause rather than the effect.
CoI: None ProfG multiple

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  • I know the difference is significant – but is it also clinically relevant? No idea how this bladder test works.

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