New MS Study Shows TYSABRI Improves Cognitive Impairment

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Researchers at Spedali Civili of Brescia in Italy recently published findings in the journal PLoS One that Biogen’s Tysabri (natalizumab) can improve cognitive impairment in patients with relapsing remitting multiple sclerosis (RRMS) over the course of at least three years. The study is entitled “Natalizumab Significantly Improves Cognitive Impairment over Three Years in MS: Pattern of Disability Progression and Preliminary MRI Findings.

MS is a chronic, progressive neurodegenerative disorder that results from the attack on the central nervous system (brain, spinal cord and optical nerves) by the body’s own immune system, causing inflammation and damage to the myelin layer that covers and protects neurons. Myelin loss leads to impairment in signal transmission along the nerve fibers, affecting motor function (coordination, balance, speech and vision), causing irreversible neurological disability and paralysis. Most MS patients experience their first symptom between 20 and 40 years of age and it is estimated that more than 2.3 million people in the world suffer from the disease. There is currently no cure for MS.

RRMS is the most frequent form of the disease, which is clinically characterized by recurring episodes of neurological symptoms. Natalizumab (Tysabri, Biogen) is a humanized monoclonal antibody used in the treatment of RRMS patients and it has been shown to reduce disease activity. Patients under natalizumab treatment for 6 months to 2 years have been found to have a significant reduction in the decline of their cognitive functions; some patients even experience an improvement in cognitive abilities. A reduction in relapse rate has also been reported. However, the long-term effects of natalizumab therapy on cognitive performance beyond the second year of treatment are unknown.

In the study, researchers investigated the impact of natalizumab treatment on cognitive impairment in a cohort of 24 patients with RRMS who were treated for 3 years. Patients were assessed through neuropsychological tests and in terms of relapse rate and expanded disability status scale (EDSS) score.

Researchers found that after three years of natalizumab treatment, a significant reduction in the number of impaired neuropsychological tests was achieved, along with a considerable decrease in annualized relapse rate and a stable EDSS in comparison to baseline. A particular significant improvement was found in memory, attention and executive function test scores.

The team also analyzed brain cortical atrophy in a patient subgroup through magnetic resonance imaging (MRI). Preliminary results showed that after 3 years of natalizumab treatment there were no alterations in gray matter volume but a significantly greater parahippocampal and prefrontal gray matter density, which correlated with the neuropsychological improvement observed.

The research team concluded that natalizumab therapy can reduce cognitive impairment in RRMS patients in a long-term period of three years. The team suggests that natalizumab most likely has a neuroprotective role concerning cortical gray matter in the brain.

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Patrícia holds her PhD in Medical Microbiology and Infectious Diseases from the Leiden University Medical Center in Leiden, The Netherlands. She has studied Applied Biology at Universidade do Minho and was a postdoctoral research fellow at Instituto de Medicina Molecular in Lisbon, Portugal. Her work has been focused on molecular genetic traits of infectious agents such as viruses and parasites.
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  1. James B Morey says:

    Dr Silva, what I’ve read has definitely picked my interest. First of all if there is a possibility of gaining back some of my mental faculties that would be a huge success, especially when people constantly tell me I’m never getting better. I just can’t personally accept that. If Tudyk ltysabri helps rejuvenate plaques and brain tissue then by that rationale there’s a possibility it COULD help with the pain I’ve been ensuring for the last two years. My current neurologist doesn’t Instagram it and the pain clinic’s are dealing with drug addicts and people like myself are constantly overlooks. I’ve never had issues like this with drs. It’s worse now that I’m in a small town in the middle of nowhere. My biggest a question, is tysabri available here in the United States, and if so what are my options?
    …. .. .Jim Morey

    • Patricia Silva, PhDPatricia Silva, PhD says:

      Dear Jim Morey, you can find more information regarding Tysabri in the following website:
      Tysabri is available in the United States but since it is associated with an increased risk of developing progressive multifocal leukoencephalopathy (PML, a serious brain infection), it is only available through a restricted program under a Risk Evaluation and Mitigation Strategy (REMS) called the TOUCH Prescribing Program. More informatiom on the program and how you can access it can be found on this link:
      I sincerely wish you all the best.

  2. Stuart says:

    For me, Tysabri was a rescue drug and for me, I have been thinking clearly since I began using… Like any medication, this is not for everybody. I am just glad, that it continues to work for me.

  3. I’ve tried almost all of the self-injection types of MS medications in the span of a year (2009). They all left me relapsing without any sign of it stopping. I was so scared of getting PML that I left Tysabri as my final and last resort. I can honestly say that I wish I went straight to it without trying any of the interferons. It’s been over six years now that I haven’t relapsed and I see Tysabri as the wonder drug of the century. It seriously saved my life. Aside from the usual side effects like fatigue and depression, I’m basically taking the least medication possible for a person with RRMS. I’m basing my previous statement on people I know with RRMS. I know there are some who don’t take anything at all and are still able to cope.
    Like Stuart, I’m glad that Tysabri works for me and I hope it stays that way until someone finds a cure for this disease.

  4. Bill Martin says:

    I’ve been on Tysabri for about three years I don’t see any noticeable differences, I haven’t gotten any worse and for that I’m thankful. I’m 70 years young and still try to do the things I use to do. I find that because of balance problems I have to be extra careful and watch how I do things I’m constantly learning how to keep my balance better. I have limited my self to knowing what I can and what I can’t do. I find ways to work around those things I’m no longer able to do by developing alternatives. MS is a mystery of which researchers are finding new and better treatments all the time so be hopeful there is a cure out there it just needs to be found. Attitude is everything, Edison once said; “If you think you can or if you think you can’t your probably right.”

  5. David Kallman says:

    I know Tsabryi is indicated for only relapsing remitting MS (RRMS). I wonder if its cognitive benefits would extend to secondary progressive MS (SPMS)?

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