Natalizumab: complications
Written and reviewed by Dr Ibrahim Imam, Consultant Neurologist. Last reviewed .
Natalizumab: complications. Progressive multifocal leukoencephalopathy (PML). Fully referenced neurology checklist.
Inflammatory side effects
- Progressive multifocal leukoencephalopathy (PML)
- PML immune reconstitution inflammatory syndrome (PML-IRIS)
- Neutralising antibodies (NABs)
- Severe MS rebound: on Natalizumab withdrawal
- Epstein-Barr virus (EBV) immune reconstitution inflammatory syndrome
- Fulminant MS: this develops after the withdrawal of Natalizumab
- Cutaneous sarcoid-like reaction
- Natalizumab wearing-off effect: this occurs in 54% of people
Post-natalizumab MS reactivation: risk factors
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Neoplastic side effects (case reports)
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Herpes infections
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Other infections
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Other side effects: case reports
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References
- Torkildsen Ø, Myhr KM, Bø L. Disease-modifying treatments for multiple sclerosis – a review of approved medications. Eur J Neurol 2016; 23(Suppl 1):18-27.
- Kappos L,Bates D, Edan G, et al. Natalizumab treatment for multiple sclerosis: updated recommendations for patient selection and monitoring. Lancet Neurol 2011; 10:745-758.
- Vargas DL, Tyor WR. Update on disease-modifying therapies for multiple sclerosis. J Investig Med 2017; 65:883-891.
- Wattjes MP, Wijburg MT, Vennegoor A, et al; Dutch-Belgian Natalizumab-associated PML study group. MRI characteristics of early PML-IRIS after natalizumab treatment in patients with MS. JNNP 2016; 87:879-884.
- Larochelle C, Metz I, Lécuyer MA, Terouz S, Roger M, Arbour N, Brück W, Prat A. Immunological and pathological characterization of fatal rebound MS activity following natalizumab withdrawal. Mult Scler 2016; pii:1352458516641775 [epub ahead of print].
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