Natalizumab en esclerosis múltiple / Natalizumab in multiple sclerosis

Introducción y desarrollo. El natalizumab es un anticuerpo monoclonal dirigido contra la integrina alfa-4 que ha demostrado una eficacia marcada en el tratamiento de la esclerosis múltiple. Los ensayos clínicos publicados demuestran una reducción significativa de la tasa de brotes y una disminución de la progresión de la discapacidad y de la actividad de la enfermedad medida mediante resonancia magnética. El natalizumab se tolera bien, aunque se han descrito efectos secundarios graves que han condicionado su uso como fármaco de segunda línea para el tratamiento de la esclerosis múltiple en aquellos pacientes que muestran una falta de respuesta a los inmunomoduladores convencionales. Conclusiones. Los últimos datos en pacientes de estas características continúan demostrando que el natalizumab sigue presentando un perfil de eficacia y seguridad muy bueno. La presente revisión examina los últimos datos sobre la respuesta al natalizumab en pacientes que presentan un fallo terapéutico a los fármacos convencionales (AU)

Introduction and development. Natalizumab is a monoclonal antibody targeted against alpha-4 integrin that has proved to be very effective in the treatment of multiple sclerosis. The results of clinical trials published to date show a significant reduction in the rate of outbreaks and a decrease in the progression of the disability and of the disease activity as measured by means of magnetic resonance imaging. Natalizumab is well tolerated, although severe side effects have been reported that have conditioned its use as a second-line drug for the treatment of multiple sclerosis in patients who do not respond to conventional immunomodulators. Conclusions. The latest data in patients with these characteristics continue to show that natalizumab still offers a very good effectiveness and safety profile. This review examines the latest data on the response to natalizumab in patients who fail to respond to therapy with conventional drugs (AU)

[Natalizumab in multiple sclerosis]. / Natalizumab en esclerosis múltiple.

INTRODUCTION AND DEVELOPMENT: Natalizumab is a monoclonal antibody targeted against alpha-4 integrin that has proved to be very effective in the treatment of multiple sclerosis. The results of clinical trials published to date show a significant reduction in the rate of outbreaks and a decrease in the progression of the disability and of the disease activity as measured by means of magnetic resonance imaging. Natalizumab is well tolerated, although severe side effects have been reported that have conditioned its use as a second-line drug for the treatment of multiple sclerosis in patients who do not respond to conventional immunomodulators. CONCLUSIONS: The latest data in patients with these characteristics continue to show that natalizumab still offers a very good effectiveness and safety profile. This review examines the latest data on the response to natalizumab in patients who fail to respond to therapy with conventional drugs.

[Magnetic resonance in the clinical and therapeutic follow-up of multiple sclerosis]. / Resonancia magnética en el seguimiento clínico y terapéutico de la esclerosis múltiple.

Magnetic resonance is the most sensitive para-clinical method available for the diagnosis of multiple sclerosis since it shows changes in 95% of the patients with clinically definite multiple sclerosis. However, little correlation has been found, in different studies, between the parameters of magnetic resonance and the degree of neurological disability. The development and gradual application of new techniques of magnetic resonance, which permit specific detection of the lesions with the greatest degree of nerve dysfunction, permits improvement in the use of this technique for study of the natural history of the disease and thus to monitor patients given new treatments.

Resonancia magnética en el seguimiento clínico y terapéutico de la esclerosis múltiple / Magnetic resonance in the clinical and therapeutic follow-up of multiple sclerosis

La resonancia magnética es el método paraclínico más sensible en el diagnóstico de esclerosis múltiple ya que muestra alteraciones en el 95 por ciento de pacientes con esclerosis múltiple clínicamente definida; sin embargo, la correlación obtenida en diferentes estudios entre los parámetros que ofrece la resonancia magnética y el grado de discapacidad neurológica ha sido escasa. El desarrollo y progresiva aplicación de nuevas técnicas de resonancia magnética, que permiten detectar de forma específica aquellas lesiones que traducen un mayor grado de disfunción neuronal, está permitiendo optimizar la utilización de esta técnica en el estudio de la historia natural de la enfermedad y, consiguientemente, en la monitorización de los enfermos que son sometidos a nuevos tratamientos (AU)