, Volume 256, Issue 10, pp 1771-1772
Date: 16 Jul 2009

Melanoma complicating treatment with Natalizumab (Tysabri) for multiple sclerosis

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Sirs,

Natalizumab (Tysabri, Biogen Idec and Elan Pharmaceuticals) is a humanized monoclonal antibody which targets the α4 subunits of the cellular adhesion molecules α4β1 and α4β7 integrins, blocking their interaction with their co-receptors VCAM-1, CS-1 and MadCAM-1 [3, 15]. This action reduces leukocyte trafficking into the brain and gut and mediates the beneficial effect of natalizumab in multiple sclerosis (MS) and Crohn’s disease [3]. The efficacy of natalizumab in patients with relapsing remitting MS was demonstrated in two phase III studies, AFFIRM and SENTINAL [10, 12]. These studies showed that when natalizumab was used as mono therapy or in combination with interferon beta-1a (Avonex) it significantly reduced relapse rate and slowed the progression of disability. Natalizumab was well tolerated with the most common adverse effects being headache, infusion reactions and a modest increase in urinary and respiratory tract infections [10, 12]. Neither trial identified any apparent ...