A real world multi center study on efficacy and safety of natalizumab in Indian patients with multiple sclerosis

Mult Scler Relat Disord. 2022 Oct:66:104059. doi: 10.1016/j.msard.2022.104059. Epub 2022 Jul 25.

Abstract

Background: Natalizumab (NTZ) is increasingly being used in Indian multiple sclerosis (MS) patients. There are no reports on its safety and efficacy, especially with respect to the occurrence of progressive multifocal leukoencephalopathy (PML).

Objectives: To describe the patient characteristics, treatment outcomes, and adverse events, especially the occurrence of PML in NTZ-treated patients.

Methods: A multicentre ambispective study was conducted across 18 centres, from Jan 2012 to Dec 2021. Patients at and above the age of 18 years treated with NTZ were included. Descriptive and comparative statistics were applied to analyze data.

Results: During the study period of 9 years, 116 patients were treated with NTZ. Mean age of the cohort was 35.6 ± 9.7 years; 83/116 (71.6%) were females. Relapse rate for the entire cohort in the year before NTZ was 3.1 ± 1.51 while one year after was 0.20±0.57 (p = 0.001; CI 2.45 -3.35). EDSS of the entire cohort in the year before NTZ was 4.5 ± 1.94 and one year after was 3.8 ± 2.7 (p = 0.013; CI 0.16-1.36). At last follow up (38.3 ± 22.78 months) there were no cases of PML identified.

Conclusions: Natalizumab is highly effective and safe in Indian MS patients, with no cases of PML identified at last follow up.

Keywords: EDSS score; JC virus; Multiple sclerosis; Natalizumab; Progressive multifocal leukoencephalopathy; Relapse rate.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Female
  • Humans
  • Immunologic Factors / adverse effects
  • Leukoencephalopathy, Progressive Multifocal* / chemically induced
  • Leukoencephalopathy, Progressive Multifocal* / etiology
  • Male
  • Middle Aged
  • Multiple Sclerosis* / chemically induced
  • Multiple Sclerosis* / drug therapy
  • Multiple Sclerosis, Relapsing-Remitting* / chemically induced
  • Multiple Sclerosis, Relapsing-Remitting* / drug therapy
  • Natalizumab / adverse effects
  • Nitro Compounds
  • Thiazoles

Substances

  • Immunologic Factors
  • Natalizumab
  • Nitro Compounds
  • Thiazoles
  • nitazoxanide