This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
Natalizumab (Tysabri®, Biogen Idec Inc., Cambridge, MA) is a recombinant humanized monoclonal antibody that binds to the α4 chain of the integrin very late activation antigen (VLA)-4 and to α4β7 integrin. It was designed to diminish the adherence of activated leukocytes to biologic membranes and their subsequent migration into peripheral tissues, including the brain and the spinal cord. The clinical effectiveness of natalizumab in patients with relapsing-remitting multiple sclerosis (MS) was evaluated in 2 phase 3 clinical trials (the AFFIRM monotherapy trial1 and the SENTINEL add-on trial with interferon beta-1a [Avonex®, Biogen Idec Inc.]2).
In the United States, the Food and Drug Administration first approved natalizumab on November 24, 2004, for the treatment of relapsing forms of MS. Only 3 months later, the manufacturers of natalizumab announced its voluntary withdrawal after 2 patients with MS and 1 patient with Crohn disease who had received natalizumab in clinical trials were diagnosed with progressive multifocal leukoencephalopathy (PML).3–5 PML, a brain demyelinating disorder caused by the human polyomavirus JC, is almost exclusively diagnosed in individuals who experience severe and prolonged immunosuppression. The occurrence of PML in patients with MS treated with natalizumab was unexpected to many because there …
AAN Members
We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.
AAN Non-Member Subscribers
Purchase access
Letters: Rapid online correspondence
REQUIREMENTS
You must ensure that your Disclosures have been updated within the previous six months. Please go to our Submission Site to add or update your Disclosure information.
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
