Drug Shows Promise for Treating Multiple Sclerosis

A phase II study has shown that an investigational drug reduced new inflammatory brain lesions and relapses in patients with relapsing forms of multiple sclerosis (MS). The study was published in the January 2, 2003, issue of The New England Journal of Medicine.

The multicenter study involved 213 MS patients, who received either one of two doses of a drug called natalizumab or placebo by intravenous infusion every four weeks for six months. Participants had either relapsing-remitting MS or secondary progressive MS. An analysis based on magnetic resonance imaging (MRI) scans showed that patients treated with natalizumab for six months had up to 93% reduction in new gadolinium-enhancing lesions compared to patients on placebo. In the placebo patients, 38% experienced one or more relapses, compared to only 19% of patients treated with natalizumab. Additional trials are now under way.

Natalizumab is the first in a new class of compounds known as selective adhesion molecule (SAM) inhibitors. It binds to a specific adhesion molecule on the immune cell surface known as alpha-4 integrin. By binding to alpha-4 antegrin, natalizumab may inhibit immune cells from leaving the bloodstream and prevent them from migrating into the brain or the inflamed gut tissue and worsening the disease condition. Natalizumab was discovered in the San Francisco research facilities of Elan Corp. plc (Dublin, Ireland), and both Elan and Biogen (Cambridge, MA, USA) have pioneered research into this novel pathway.

"The phase II results were promising and demonstrated the ability of natalizumab to reduce MRI activity and the number of relapses,” said David Miller, M.D., lead author of the study and professor of neurology, Institute of Neurology (London, UK).





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