Safety and Efficacy of Natalizumab in the Treatment of Multiple Sclerosis
What it found
The main measure showed a statistically significant benefit.
“Natalizumab reduced the risk of sustained progression of disability by 42 percent over two years (hazard ratio, 0.58; 95 percent confidence interval, 0.43 to 0.77; P<0.001).”Read by software from the paper's abstract
two years
| Group | n | Value |
|---|---|---|
| natalizumab | 627 | 17 percent cumulative probability of progression |
| placebo | 315 | 29 percent cumulative probability of progression |
hazard ratio 0.58 (95% CI 0.43–0.77)
p = <0.001
Total participants: 942
Read by software from the paper's abstract
What was tested
Treatment tested
- Natalizumab
Integrin alpha-4/beta-1 inhibitor|Integrin alpha-4/beta-7 inhibitor
Placebo or sham
- Placebo
What it measured
Main measures
The primary objectives of this study are to determine whether natalizumab, when compared with placebo, is effective in reducing the rate of clinical relapses at 1 year and, in slowing the progression of disability at 2 years.
1 year and 2 years
Relapses
Other measures (1)
Reduction in MRI changes and clinical relapses
1 year
RelapsesMRI lesions
Who could take part
Relapsing MS · 18 to 50
Inclusion Criteria: * Diagnosis of MS, as defined by McDonald et al., criteria # 1-4 (McDonald et al., 2001) * Between the ages of 18 and 50, inclusive. * Baseline EDSS score between 0.0 and 5.0, inclusive. * Have experienced at least one relapse within the 12 months prior to randomization. * Cranial MRI scan demonstrating lesion(s) consistent with MS. * Have given written informed consent to participate in the study. Exclusion Criteria: * Primary progressive, secondary progressive, or progressive relapsing MS. * MS relapse has occurred,in the opinion of the investigator, within 50 days prior to randomization and/or the subject has not stabilized from a previous relapse. * A clinically significant infectious illness within 30 days prior to randomization. * History of, or abnormal laboratory results indicative of any significant cardiac, endocrinologic, hematologic, hepatic, immunologic, metabolic, urologic, pulmonary, gastrointestinal, dermatologic, psychiatric, renal and/or other major disease, that in the opinion of the investigator, would preclude the administration of a recombinant humanized antibody immunomodulating agent for 116 weeks. * History of severe allergic or anaphylactic reactions or known drug hypersensitivity. * Unable to perform the Timed 25-foot Walk, 9HPT, and PASAT 3. * Abnormal blood tests performed at the Screening Visit.
As registered. Criteria can change, so ask the trial team or your neurologist.
About this trial
In the sponsor's words
The purpose of this study is to determine the safety and efficacy of natalizumab in the treatment of individuals who have been diagnosed with relapsing remitting multiple sclerosis (MS). It is hoped that natalizumab will prevent certain types of white blood cells from moving out of the bloodstream into organs, including the brain, that are being damaged by autoimmune disease (a disease in which the body's own immune system attacks certain organs). These white blood cells are thought to cause inflammation that can result in lesions (small areas of damage) in the brain. These lesions are thought to be the cause of relapses and disability in MS.
Papers
Results
Utility of Progression Independent of Relapse Activity as a Trial Outcome in Relapsing-Remitting Multiple Sclerosis.Neurology · 2025
Results
Natalizumab reduces loss of gray matter and thalamic volume in patients with relapsing-remitting multiple sclerosis: A post hoc analysis from the randomized, placebo-controlled AFFIRM trial.Mult Scler · 2024
Results
Measuring treatment response to advance precision medicine for multiple sclerosis.Ann Clin Transl Neurol · 2021
Results
Pharmacokinetics and pharmacodynamics of natalizumab in pediatric patients with RRMS.Neurol Neuroimmunol Neuroinflamm · 2019
Results
Reversibility of the effects of natalizumab on peripheral immune cell dynamics in MS patients.Neurology · 2017
Results
Impact of natalizumab on ambulatory improvement in secondary progressive and disabled relapsing-remitting multiple sclerosis.PLoS One · 2013
Results
A randomized, placebo-controlled trial of natalizumab for relapsing multiple sclerosis.N Engl J Med · 2006
Natalizumab reduced the risk of sustained progression of disability by 42 percent over two years (hazard ratio, 0.58; 95 percent confidence interval, 0.43 to 0.77; P<0.001).
Read by software from the paper's abstract
Results
Strijbis EM, Coerver E, Mostert J, van Kempen ZLE, Killestein J, Comtois J, Repovic P, Bowen JD, Cutter G, Koch M. Association of age and inflammatory disease activity in the pivotal natalizumab clinical trials in relapsing-remitting multiple sclerosis. J Neurol Neurosurg Psychiatry. 2023 Oct;94(10):792-799. doi: 10.1136/jnnp-2022-330887. Epub 2023 May 12.Results
Balcer LJ, Galetta SL, Polman CH, Eggenberger E, Calabresi PA, Zhang A, Scanlon JV, Hyde R. Low-contrast acuity measures visual improvement in phase 3 trial of natalizumab in relapsing MS. J Neurol Sci. 2012 Jul 15;318(1-2):119-24. doi: 10.1016/j.jns.2012.03.009. Epub 2012 Apr 21.Background
Voloshyna N, Havrdova E, Hutchinson M, Nehrych T, You X, Belachew S, Hotermans C, Paes D. Natalizumab improves ambulation in relapsing-remitting multiple sclerosis: results from the prospective TIMER study and a retrospective analysis of AFFIRM. Eur J Neurol. 2015 Mar;22(3):570-7. doi: 10.1111/ene.12618. Epub 2014 Dec 15.
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Linked trials
Extended by
STRATAPhase 3 · Stopped early
Extended by
Natalizumab Re-Initiation of DosingPhase 3 · Completed
Links found where a registry record names another trial's registry number.
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History
Started
Nov 2001
Main results due
Nov 2004
Finished
Jan 2005
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