Clinical relevance of serum natalizumab concentration and anti-natalizumab antibodies in MS

This research group from the Netherlands performed a prospective observational study of 73 people with MS treated with natalizumab. They measured serum natalizumab levels and antibody titres before the start of natalizumab treatment, at weeks 12 and 24 and then each year after natalizumab initiation. Serum natalizumab was measured using a newly developed enzyme linked immunosorbent assay (ELISA) and anti-natalizumab antibodies were measured with radioimmunossay. MRI scans were preformed on a 1.5 Tesla scanner and clinical examination was carried out prior to the start of natalizumab and annually thereafter. All patients developed their antibodies by week 24.

Results from this study reveal that low or undetectable natalizumab serum concentrations and high antibody titers are associated with a lack of efficacy of natalizumab. It raises the question of measuring serum natalizumab in the future, using a highly specific assay, which may lead to more enhanced precision in using natalizumab in individual patients.

authors: Vennegoor A, Rispens T, Strijbis EM, Seewann A, Uitdehaag BM

source:
Mult Scler. 2012 Sep 19. [Epub ahead of print]

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