Abstract

Aims: To describe clinical outcomes and tolerability of natalizumab in patients with relapsing-remitting multiple sclerosis at Mohammed V Military Teaching Hospital in Rabat. Study Design: Retrospective, single-center observational case series.

Place and duration of study: Department of Neurology, Mohammed V Military Teaching Hospital, Rabat, Morocco, January 2013 to March 2023. Methodology: We reviewed records of 14 patients treated with natalizumab and extracted relapse history, Expanded Disability Status Scale (EDSS) scores, magnetic resonance imaging (MRI) findings, JC virus antibody status, and adverse events.

Results: Mean age was 37.6 ± 13.1 years; 10 patients (71.4%) were women. Natalizumab was initiated as first-line therapy in five patients and after interferon beta-1a in nine. Six patients (42.9%) had no documented relapse during natalizumab treatment. In eight patients with available data, mean annualized relapse rate was 2.0 before any disease-modifying treatment and 1.6 during natalizumab treatment. Mean EDSS scores were 3.88 before initial treatment and 2.19 after natalizumab, but these assessments occurred at different treatment stages. Five patients had nonserious adverse events, one had anaphylaxis, and one had MRI findings suspicious for progressive multifocal leukoencephalopathy without documented confirmation. Three patients discontinued natalizumab.

Conclusion: This small retrospective series describes clinical experience with natalizumab in a military teaching hospital. Differences in follow-up and missing paired measurements preclude causal estimates of effectiveness; suspected progressive multifocal leukoencephalopathy should not be counted as a confirmed event.

Keywords

multiple sclerosis, natalizumab, retrospective studies, relapse, disability, progressive multifocal leukoencephalopathy