1 Recommendations


Natalizumab (branded or biosimilar) is recommended as an option for the treatment only of rapidly evolving severe relapsing–remitting multiple sclerosis (RES). RES is defined by two or more disabling relapses in 1 year, and 1 or more gadolinium-enhancing lesions on brain magnetic resonance imaging (MRI) or a significant increase in T2 lesion load compared with a previous MRI.


People currently receiving natalizumab, but for whom treatment would not have been recommended according to section 1.1 of this guidance, should have the option to continue therapy until they and their clinicians consider it appropriate to stop.