Natalizumab Improves Cognitive Function in Multiple Sclerosis

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Investigators observed improvements in all 7 cognitive domains from baseline to 2 years.
Investigators observed improvements in all 7 cognitive domains from baseline to 2 years.

Natalizumab significantly improved cognitive functions after 2 years of treatment for patients with relapsing multiple sclerosis, according to a study published in CNS Drugs.

Researchers used NeuroTrax, a computer-based diagnostic tool for cognitive profile measurements, to monitor patient's cognitive function while on natalizumab. In this retrospective review, researchers analyzed scores of patients with relapsing-remitting multiple sclerosis who had a baseline, at least 2 NeuroTrax scores between 10 and 30 months apart, and were taking intravenous natalizumab (300 mg) every 4 weeks for at least 2 years. The cognitive assessments analyzed the domains of memory, executive function, visual-spatial processing, verbal functioning, attention, information processing speed, motor function, and a global cognitive score.

At baseline, 42.3% of the 52 patients had a disease duration of 5 years or less, and 76.9% of patients had prior treatment with another therapy. By year 2, there was significant improvement in the global cognitive scores (P =.003), and all 7 domain scores improved, with significant improvements in verbal functioning (P =.007). At baseline, 21.2% of patients scored in the impairment category for global cognitive score, but by year 2, this had dropped to 13.5%, and 32.7% of patients saw significant improvements in their global cognitive score. These results held true whether or not the patient had prior treatment with another therapy.  The greatest relative reductions were seen in patients with impairment for attention (26.9%) and information processing speed domains (39.2%).

Future studies need to include a control group, a larger study population to incorporate more diversity, and long-term follow-ups.

In conclusion, patients with multiple sclerosis treated with natalizumab displayed improved cognitive function over a 2-year time span. These results warrant further research to understand the mechanics behind the improvement.

This study was supported by the Biogen. Please refer to reference for a complete list of authors' disclosures.

Reference

Gudesblatt M, Wisseman K, Zarif M, et al. Improvement in cognitive function as measured by NeuroTrax in patients with relapsing multiple sclerosis treated with natalizumab: a 2‑year retrospective analysis [published online August 24, 2018] CNS Drugs. doi: 10.1007/s40263-018-0553-1

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