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Natalizumab

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Natalizumab, Tysabri

  • See Also
  1. Integrin Receptor Antagonist
  2. Vedolizumab
  • Indications
  1. Multiple Sclerosis (relapsing)
  2. Moderate to severe Inflammatory Bowel Disease (refractory to TNF Inhibitors)
    1. Ulcerative Colitis
    2. Crohns Disease
  • Contraindications
  1. Severe Infection
  • Mechanism
  1. Integrin Receptor Antagonist
  • Precautions
  1. See Monoclonal Antibody for preparation before first dose
  • Dosing
  1. Infuse 300 mg IV over 1 hour every 4 weeks
  2. Discontinue if insignificant clinical response at 12 weeks or unable to taper off chronic Corticosteroids at 6 months
  • Safety
  1. Unknown safety in pregnancy
  2. Unknown safety in Lactation
  • Adverse Effects
  1. Anaphylaxis
  2. Medication reaction
  3. Other serious adverse effects
    1. Elevated Liver Function Tests (Transaminitis, Hyperbilirubinemia)
    2. Progressive Multifocal Leukoencephalopathy (PML)
      1. Obtain John Cunningham Virus (JCV) Antibody every 6 months
      2. Discontinue Natalizumab if positive Antibody (increased PML risk)
      3. Discontinue (and MRI) if motor weakness, Incoordination or personality changes
  • Efficacy
  1. Slower effects than with TNF Inhibitors
  • Resources
  1. Natalizumab (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=c5fdde91-1989-4dd2-9129-4f3323ea2962
  • References
  1. (2023) Biologics for Crohn's Disease, Presc Lett, #390826
  2. (2023) Drugs for Inflammatory Bowel Disease, Med Lett Drug Ther 65: 105-12