Effect of natalizumab on conversion of gadolinium enhancing lesions to T1 hypointense lesions in relapsing multiple sclerosis.

摘要: Background:. Natalizumab, a humanized monoclonal anti-adhesion molecule antibody, reduces the frequency of new gadolinium (Gd) enhancing lesions and relapses in multiple sclerosis (MS). Its effect on evolution Gd to T1 hypointense is unknown. Methods:. 213 patients were randomized receive 3 mg/kg or 6 natalizumab placebo monthly for months then followed further months. A subset who had one more from Month 0 available electronic data analysed. Each lesion that developed during treatment (months 1-6) was investigated conversion at month 12. Lesions classified as large small if their cross-sectional area greater less than 20mm(2). Because similarity both doses lesions, two arms combined all analyses. Results:. Compared with group, group exhibited significant decreases in: (i) proportion evolved T1-hypointense (10/38 [26 %] versus 27/40 [68 %]; p < 0.01); (ii) (2/38 [5 16/40 [40 (iii) became (11/75 [15 118/466 [25 = 0.045); (iv) mean per patient converted (0.15 0.28; 0.005), (v) odds ratio (OR) converting (OR 0.48; 95% CI 0.24, 0.94, 0.031)). Conclusion:. Natalizumab significantly suppresses lesions. This may reflect several mechanisms including reduced cell migration across blood brain barrier, T activation within an inhibitory subsequent axonal damage central nervous system lesion, likelihood recurrent inflammation.