Natalizumab (originator and biosimilar) for treating highly active relapsing–remitting multiple sclerosis after disease-modifying therapy

Natalizumab (subcutaneous originator and intravenous biosimilar)

Natalizumab (subcutaneous originator and intravenous biosimilar) is available on the NHS as a possible treatment for highly active relapsing–remitting multiple sclerosis (RRMS) in adults, if:

• it has not responded to a full and adequate course of at least 1 disease-modifying therapy
• the characteristics of the person and the activity of their MS mean that cladribine is not suitable.

If you have natalizumab, you will be offered regular anti‑John Cunningham human polyomavirus antibody level tests before and during treatment.

Natalizumab (intravenous originator)

Natalizumab (intravenous originator) is not normally available on the NHS for treating highly active RRMS that has not responded to a full and adequate course of at least 1 disease-modifying therapy in adults.

Your healthcare professional should talk with you about other treatment options. If you are already having it, you should be able to continue until you and your healthcare professional decide when best to stop.

About these recommendations

An originator is the branded biological medicine that was originally licensed. A biosimilar is a biological medicine that is expected to work as well as, and be as safe as, the originator.

If you are not eligible for natalizumab (original or biosimilar) but are already having it, you should be able to continue until you and your healthcare professional decide when best to stop.

Is this treatment right for me?

Your healthcare professionals should give you clear information, talk with you about your options and listen carefully to your views and concerns. Your family can be involved too, if you wish. See our webpage on shared decision making.

Questions to think about

• How well does it work compared with other treatments?
• What are the risks or side effects? How likely are they?
• How will the treatment affect my day-to-day life?
• What happens if the treatment does not work?
• What happens if I do not want to have treatment? Are there other treatments available?

Information and support

The NHS webpage on MS may be a good place to find out more.

These organisations can give you advice and support:

• MS Trust, 0800 032 3839
• MS society, 0808 800 8000

You can also get support from your local Healthwatch.

NICE is not responsible for the quality or accuracy of any information or advice provided by these organisations.

ISBN: 978-1-4731-8646-0