Multiple Sclerosis: Monoclonal Antibody Tysabri Reduces Brain Inflammation

Jeppe Romme Christensen  MD PhD From the Danish Multiple Sclerosis Center Copenhagen University Hospital Hvidovre, Interview with:
Jeppe Romme Christensen  MD PhD
From the Danish Multiple Sclerosis Center
Copenhagen University Hospital Hvidovre, Denmark. What are the main findings of the study?

Dr. Christensen: This study demonstrates that progressive multiple sclerosis (MS) patients have reduced inflammation and tissue damage in the brain after treatment with natalizumab. These findings highlight that progressive MS is an inflammatory disease and furthermore that peripheral circulating immune cells contribute to brain inflammation and tissue damage in progressive MS. Were any of the findings unexpected?

Dr. Christensen: It is a common view that progressive MS disease activity is caused by neurodegenerative mechanisms independent of inflammation. In this view, our findings may appear unexpected. However, the findings are in agreement with accumulating evidence from pathology and biomarker studies which have indicated that progressive MS is characterized by continuing widespread inflammation in the brain with accompanying axonal damage and disease progression. What should clinicians and patients take away from your report?

Dr. Christensen: First of all the study emphasizes that inflammation is central in progressive multiple sclerosis and accessible for anti-inflammatory treatment with corresponding beneficial effects on axonal damage and demyelination.

Secondly, the findings are promising for future development of therapies for progressive MS and provide a novel design for progressive MS clinical trials. What recommendations do you have for future research as a result of this study?

Dr. Christensen: Future development of treatments for progressive multiple sclerosis is urgently needed. This study demonstrates that peripheral and brain inflammation is associated with tissue damage, and therefore should be one of the first considerations in the future development of treatments for progressive MS.

Furthermore, this study show practicality of the use cerebrospinal fluid biomarkers which should be considered in progressive multiple sclerosis proof-of-concept trials, as these biomarkers provide important information on brain inflammation and tissue damage and allows studies on small populations with short-duration.


Natalizumab in progressive MS Results of an open-label, phase 2A, proof-of-concept trial
Jeppe Romme Christensen, MD, PhD, Rikke Ratzer, MD, Lars Börnsen, MD, PhD, Mark Lyksborg, PhD, Ellen Garde, MD, PhD, Tim B. Dyrby, PhD, Hartwig R. Siebner, MD, DMSc, Per S. Sorensen, MD, DMSc and Finn Sellebjerg, MD, PhD, DMSc

Published online before print March 28, 2014, doi: 10.1212/WNL.0000000000000361 Neurology 10.1212/WNL.0000000000000361



Last Updated on April 3, 2014 by Marie Benz MD FAAD