Products
Natalizumab is commercially available as a concentrate for the preparation of an infusion solution (Tysabri). It has been approved in many countries since 2007.
Structure and properties
Natalizumab is a recombinant and humanized IgG4ϰ antibody produced in mouse cells that binds to α4-integrins.
Effects
Natalizumab (ATC L04AA23) has selective immunosuppressive properties. The effects are due to binding to the α4-subunit of α4β1- and α4β7-integrins. These integrins are found on leukocytes. The binding inhibits the passage of leukocytes from blood vessels into inflamed tissues and the nervous system.
Indications
For the treatment of highly active relapsing-remitting multiple sclerosis. Natalizumab is also approved in some countries for the treatment of Crohn’s disease.
Dosage
According to the SmPC. The drug is administered as an intravenous infusion every four weeks.
Contraindications
- Hypersensitivity
- Progressive multifocal leukoencephalopathy
- Increased risk of opportunistic infections
- Combination with interferon beta or glatiramer acetate.
- Active malignancies
For complete precautions, see the drug label.
Interactions
Natalizumab should not be combined with interferon beta or glatiramer acetate.
Adverse effects
The most common possible adverse effects include nausea, vomiting, joint pain, infectious disease, headache, dizziness, fever, fatigue, and hives.