ArticleMultiple sclerosis journal - experimental, translational and clinical
Clinical relevance and predictors of anti-natalizumab antibodies in multiple sclerosis: A real-world retrospective cohort study.
Article in Multiple sclerosis journal - experimental, translational and clinical. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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11 authors.
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Abstract
Background: Natalizumab is effective for relapsing MS but may trigger anti-natalizumab antibodies (ANZ) that neutralise drug activity and increase reactions. Trials report persistent antibodies in ∼6% and overall prevalence between 4% and 14%, but real-world burden and optimal testing remain uncertain. We assessed ANZ prevalence, timing, and correlates, comparing systematic with indication-driven testing. Methods: Single-centre retrospective cohort of natalizumab-treated patients with ≥1 ANZ test. Testing followed routine care: systematic screening at months 6/12/18 or testing triggered by suspected inefficacy or infusion reactions. Clinical/MRI data were abstracted; time to positivity was used in Kaplan-Meier; predictors were assessed using multivariable logistic regression. Results: Among 182 patients (348 tests), ANZ were detected in nine (4.9%; four persistent and five transient), all within the first 12 infusions. Positivity differed by indication ( Conclusions: In routine care, ANZ positivity is uncommon and occurs early. Indication-driven testing - especially when prompted by new MRI lesions - yields greater diagnostic value than routine screening of clinically stable patients, supporting a selective, context-driven approach to ANZ monitoring.
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