Smokers run increased risk of developing anti-natalizumab antibodies

Natalizumab is a monoclonal antibody which prevents leukocyte migration across the blood brain barrier and, as a result, reduces inflammation in the central nervous system. A common side-effect with natalizumab therapy is the development of antidrug antibodies. The development of anti-natalizumab antibodies is associated with an increased risk of developing infusion-related adverse events.  If the antibodies persist, they are associated with a reduced clinical efficacy.

This study investigated if smoking habits among 1338 MS patients treated with natalizumab, influenced the risk of developing antidrug antibodies to natalizumab. 

The results showed that, compared to non-smokers, the odds ratio of developing anti-natalizumab antibodies was 2.4 for patients who smoked and there was a higher risk of developing antibodies with a higher intensity of smoking. When the researchers looked at smoking within two years prior to screening, the odds ratio of developing anti-natalizumab antibodies was 2.7. These findings strengthen the hypothesis of the lungs as immune-reactive organs on irritation.

Authors:Hedström A, Alfredsson L
Source: Mult Scler. 2013 Dec 5. [Epub ahead of print]
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