Natalizumab wear-off don’t relate to disease activity


Wearing-off at the end of natalizumab dosing interval and risk of MS disease activity: A prospective 1-year follow-up study.Bringeland GH, Myhr KM, Vedeler CA, Gavasso S.J Neurol Sci. 2020 May 5;415:116880. doi: 10.1016/j.jns.2020.116880. [Epub ahead of print]

Natalizumab effectively prevents disease activity in relapsing-remitting multiple sclerosis by binding α4 integrin and inhibiting leukocyte migration to the central nervous system. We recently reported an association between low natalizumab receptor occupancy and subjective wearing-off symptoms at the end of the 4-week dosing interval. Here, we aimed to evaluate the short-term risk of disease activity in a 1-year prospective follow-up of the same patient cohort (n = 40). We found that all patients available for follow-up after one year (n = 35) fulfilled the criteria for no evidence of disease activity (NEDA). Thus, wearing-off symptoms were not associated with increased short-term risk of disease activity. Longer follow-up in a larger patient cohort is required to establish whether therapeutic efficacy is maintained in patients with wearing-off symptoms.

We recent posted on your MS coke

In the time of extended dosing interval, this would beg the question are you feeling the wearing-off of the dose? If you read the post done above, it speaks to why this could be useful in the COVID era, because the extended dosing allows monocytes and CD4 cells into your brain to scrub it clear of viruses, it could allow you to scrub any inflammation causing virus from other parts of the body as inflammed lung for example can cause expression of vascular cell adhesion molecule, used by immune cells to enter tissues like the MS brain. Natalizumab blocks this. This type of information further supports the B cell ideas we have in part created.

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  • Very good explanation of mechanism of protection from immune system to help prevent and cleaning virus and others agression to the brain.
    It is very useful for me about the experience with all volunteers and the analysis of immune cells in this period of time.
    Thank you.

  • Would this mean a patient is at their most vulnerable (to COVID 19 infection) immediately after infusion?

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