Identification

Name
Natalizumab
Accession Number
DB00108  (BTD00083, BIOD00083)
Type
Biotech
Groups
Approved, Investigational
Biologic Classification
Protein Based Therapies
Monoclonal antibody (mAb)
Description

Humanized IgG4k monoclonal antibody produced in murine myeloma cells. Natalizumab contains human framework regions and the complementarity-determining regions of a murine antibody that binds to a4-integrin. Natalizumab was voluntarily withdrawn from U.S. market because of risk of Progressive multifocal leukoencephalopathy (PML). It was returned to market July, 2006.

Protein structure
Db00108
Protein chemical formula
Not Available
Protein average weight
Not Available
Sequences
Not Available
Synonyms
  • Anti-alpha4 integrin
  • Anti-VLA4
Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
TysabriInjection300 mg/15mLIntravenousElan Pharmaceuticals2004-11-232016-06-30Us
TysabriSolution300 mgIntravenousBiogen2006-11-21Not applicableCanada
TysabriInjection300 mg/15mLIntravenousBiogen2004-11-23Not applicableUs
Categories
UNII
3JB47N2Q2P
CAS number
189261-10-7

Pharmacology

Indication

For treatment of multiple sclerosis.

Structured Indications
Pharmacodynamics

In multiple sclerosis, lesions are believed to occur when activated inflammatory cells, including T-lymphocytes, cross the blood-brain barrier (BBB). Leukocyte migration across the BBB involves interaction between adhesion molecules on inflammatory cells, and their counter-receptors present on endothelial cells of the vessel wall. The clinical effect of natalizumab in multiple sclerosis may be a secondary result of its blockade of the molecular interaction of a 4b 1-integrin expressed by inflammatory cells with VCAM-1 on vascular endothelial cells, and with CS-1 and/or osteopontin expressed by parenchymal cells in the brain. α4-integrin is required for white blood cells to move into organs, therefore, natalizumab prevents these immune cells from crossing blood vessel walls to reach affected organs thereby decreasing inflamation.

Mechanism of action

Binds to the α4-subunit of α4b 1 and α4b 7 integrins expressed on the surface of all leukocytes except neutrophils, and inhibits the α4-mediated adhesion of leukocytes to their counter-receptor(s).

TargetActionsOrganism
AIntegrin alpha-4
antibody
Human
ULow affinity immunoglobulin gamma Fc region receptor III-BNot AvailableHuman
UComplement C1r subcomponentNot AvailableHuman
UComplement C1q subcomponent subunit ANot AvailableHuman
UComplement C1q subcomponent subunit BNot AvailableHuman
UComplement C1q subcomponent subunit CNot AvailableHuman
ULow affinity immunoglobulin gamma Fc region receptor III-ANot AvailableHuman
UHigh affinity immunoglobulin gamma Fc receptor INot AvailableHuman
ULow affinity immunoglobulin gamma Fc region receptor II-aNot AvailableHuman
ULow affinity immunoglobulin gamma Fc region receptor II-bNot AvailableHuman
ULow affinity immunoglobulin gamma Fc region receptor II-cNot AvailableHuman
UIntercellular adhesion molecule 1Not AvailableHuman
Absorption
Not Available
Volume of distribution
  • 5.7 ± 1.9 L [Multiple Sclerosis (MS) Patients]
  • 5.2 ± 2.8 L [Crohn's Disease (CD) Patients]
Protein binding
Not Available
Metabolism

Most likely removed by opsonization via the reticuloendothelial system when bound to leukocytes.

Route of elimination
Not Available
Half life

11 ± 4 days

Clearance
  • 16 +/- 5 mL/hour [patients with MS who did not have PML receiving the repeat IV administration of a 300 mg dose]
  • 22 +/- 22 mL/hour [Patients with Crohn's Disease receiving the repeat IV administration of a 300 mg dose]
Toxicity
Not Available
Affected organisms
  • Humans and other mammals
Pathways
Not Available
Pharmacogenomic Effects/ADRs
Not Available

Interactions

Drug Interactions
DrugInteractionDrug group
2-MethoxyethanolThe risk or severity of adverse effects can be increased when 2-Methoxyethanol is combined with Natalizumab.Experimental
AbataceptThe risk or severity of adverse effects can be increased when Abatacept is combined with Natalizumab.Approved
abetimusThe risk or severity of adverse effects can be increased when abetimus is combined with Natalizumab.Investigational
ActeosideThe risk or severity of adverse effects can be increased when Acteoside is combined with Natalizumab.Investigational
AdalimumabThe risk or severity of adverse effects can be increased when Adalimumab is combined with Natalizumab.Approved
AdefovirThe risk or severity of adverse effects can be increased when Adefovir is combined with Natalizumab.Investigational
AfelimomabThe risk or severity of adverse effects can be increased when Afelimomab is combined with Natalizumab.Investigational
AlefaceptThe risk or severity of adverse effects can be increased when Alefacept is combined with Natalizumab.Approved, Investigational, Withdrawn
AlemtuzumabThe risk or severity of adverse effects can be increased when Alemtuzumab is combined with Natalizumab.Approved, Investigational
AlicaforsenThe risk or severity of adverse effects can be increased when Alicaforsen is combined with Natalizumab.Investigational
AltretamineThe risk or severity of adverse effects can be increased when Altretamine is combined with Natalizumab.Approved
AmsacrineThe risk or severity of adverse effects can be increased when Amsacrine is combined with Natalizumab.Approved
AnakinraThe risk or severity of adverse effects can be increased when Anakinra is combined with Natalizumab.Approved
Antilymphocyte immunoglobulin (horse)The risk or severity of adverse effects can be increased when Antilymphocyte immunoglobulin (horse) is combined with Natalizumab.Approved
Antithymocyte immunoglobulin (rabbit)The risk or severity of adverse effects can be increased when Antithymocyte immunoglobulin (rabbit) is combined with Natalizumab.Approved
ApremilastThe risk or severity of adverse effects can be increased when Apremilast is combined with Natalizumab.Approved, Investigational
AzacitidineThe risk or severity of adverse effects can be increased when Azacitidine is combined with Natalizumab.Approved, Investigational
AzathioprineThe risk or severity of adverse effects can be increased when Azathioprine is combined with Natalizumab.Approved
BasiliximabThe risk or severity of adverse effects can be increased when Basiliximab is combined with Natalizumab.Approved, Investigational
BCG vaccineThe therapeutic efficacy of BCG vaccine can be decreased when used in combination with Natalizumab.Investigational
BegelomabThe risk or severity of adverse effects can be increased when Begelomab is combined with Natalizumab.Experimental, Investigational
BelataceptThe risk or severity of adverse effects can be increased when Belatacept is combined with Natalizumab.Approved
BelimumabThe risk or severity of adverse effects can be increased when Belimumab is combined with Natalizumab.Approved
BenznidazoleThe risk or severity of adverse effects can be increased when Benznidazole is combined with Natalizumab.Approved, Investigational
BetamethasoneThe risk or severity of adverse effects can be increased when Betamethasone is combined with Natalizumab.Approved, Vet Approved
BleomycinThe risk or severity of adverse effects can be increased when Bleomycin is combined with Natalizumab.Approved
BlinatumomabThe risk or severity of adverse effects can be increased when Blinatumomab is combined with Natalizumab.Approved
Brentuximab vedotinThe risk or severity of adverse effects can be increased when Brentuximab vedotin is combined with Natalizumab.Approved
BriakinumabThe risk or severity of adverse effects can be increased when Briakinumab is combined with Natalizumab.Investigational
BrodalumabThe risk or severity of adverse effects can be increased when Brodalumab is combined with Natalizumab.Approved, Investigational
BudesonideThe risk or severity of adverse effects can be increased when Budesonide is combined with Natalizumab.Approved
BusulfanThe risk or severity of adverse effects can be increased when Busulfan is combined with Natalizumab.Approved, Investigational
CabazitaxelThe risk or severity of adverse effects can be increased when Cabazitaxel is combined with Natalizumab.Approved
CanakinumabThe risk or severity of adverse effects can be increased when Canakinumab is combined with Natalizumab.Approved, Investigational
CapecitabineThe risk or severity of adverse effects can be increased when Capecitabine is combined with Natalizumab.Approved, Investigational
CarboplatinThe risk or severity of adverse effects can be increased when Carboplatin is combined with Natalizumab.Approved
CarmustineThe risk or severity of adverse effects can be increased when Carmustine is combined with Natalizumab.Approved
CastanospermineThe risk or severity of adverse effects can be increased when Castanospermine is combined with Natalizumab.Experimental
Certolizumab pegolThe risk or severity of adverse effects can be increased when Certolizumab pegol is combined with Natalizumab.Approved
ChlorambucilThe risk or severity of adverse effects can be increased when Chlorambucil is combined with Natalizumab.Approved
CisplatinThe risk or severity of adverse effects can be increased when Cisplatin is combined with Natalizumab.Approved
CladribineThe risk or severity of adverse effects can be increased when Cladribine is combined with Natalizumab.Approved, Investigational
ClofarabineThe risk or severity of adverse effects can be increased when Clofarabine is combined with Natalizumab.Approved, Investigational
Clostridium tetani toxoid antigen (formaldehyde inactivated)The therapeutic efficacy of Clostridium tetani toxoid antigen (formaldehyde inactivated) can be decreased when used in combination with Natalizumab.Approved
CorticotropinThe risk or severity of adverse effects can be increased when Corticotropin is combined with Natalizumab.Approved, Vet Approved
Cortisone acetateThe risk or severity of adverse effects can be increased when Cortisone acetate is combined with Natalizumab.Approved
Corynebacterium diphtheriae toxoid antigen (formaldehyde inactivated)The therapeutic efficacy of Corynebacterium diphtheriae toxoid antigen (formaldehyde inactivated) can be decreased when used in combination with Natalizumab.Approved
CyclophosphamideThe risk or severity of adverse effects can be increased when Cyclophosphamide is combined with Natalizumab.Approved, Investigational
CyclosporineThe risk or severity of adverse effects can be increased when Cyclosporine is combined with Natalizumab.Approved, Investigational, Vet Approved
CytarabineThe risk or severity of adverse effects can be increased when Cytarabine is combined with Natalizumab.Approved, Investigational
DacarbazineThe risk or severity of adverse effects can be increased when Dacarbazine is combined with Natalizumab.Approved, Investigational
DaclizumabThe risk or severity of adverse effects can be increased when Daclizumab is combined with Natalizumab.Approved, Investigational
DactinomycinThe risk or severity of adverse effects can be increased when Dactinomycin is combined with Natalizumab.Approved
DasatinibThe risk or severity of adverse effects can be increased when Dasatinib is combined with Natalizumab.Approved, Investigational
DaunorubicinThe risk or severity of adverse effects can be increased when Daunorubicin is combined with Natalizumab.Approved
DeflazacortThe risk or severity of adverse effects can be increased when Deflazacort is combined with Natalizumab.Approved
DenosumabThe risk or severity of adverse effects can be increased when Denosumab is combined with Natalizumab.Approved
DeoxyspergualinThe risk or severity of adverse effects can be increased when Deoxyspergualin is combined with Natalizumab.Investigational
DexamethasoneThe risk or severity of adverse effects can be increased when Dexamethasone is combined with Natalizumab.Approved, Investigational, Vet Approved
Dimethyl fumarateThe risk or severity of adverse effects can be increased when Dimethyl fumarate is combined with Natalizumab.Approved, Investigational
DinutuximabThe risk or severity of adverse effects can be increased when Dinutuximab is combined with Natalizumab.Approved
DocetaxelThe risk or severity of adverse effects can be increased when Docetaxel is combined with Natalizumab.Approved, Investigational
DoxifluridineThe risk or severity of adverse effects can be increased when Doxifluridine is combined with Natalizumab.Investigational
DoxorubicinThe risk or severity of adverse effects can be increased when Doxorubicin is combined with Natalizumab.Approved, Investigational
EculizumabThe risk or severity of adverse effects can be increased when Eculizumab is combined with Natalizumab.Approved, Investigational
EfalizumabThe risk or severity of adverse effects can be increased when Efalizumab is combined with Natalizumab.Approved, Investigational
EpirubicinThe risk or severity of adverse effects can be increased when Epirubicin is combined with Natalizumab.Approved
EstramustineThe risk or severity of adverse effects can be increased when Estramustine is combined with Natalizumab.Approved
EtanerceptThe risk or severity of adverse effects can be increased when Etanercept is combined with Natalizumab.Approved, Investigational
EtoposideThe risk or severity of adverse effects can be increased when Etoposide is combined with Natalizumab.Approved
EverolimusThe risk or severity of adverse effects can be increased when Everolimus is combined with Natalizumab.Approved
FingolimodNatalizumab may increase the immunosuppressive activities of Fingolimod.Approved, Investigational
FloxuridineThe risk or severity of adverse effects can be increased when Floxuridine is combined with Natalizumab.Approved
FludarabineThe risk or severity of adverse effects can be increased when Fludarabine is combined with Natalizumab.Approved
FludrocortisoneThe risk or severity of adverse effects can be increased when Fludrocortisone is combined with Natalizumab.Approved
FluorouracilThe risk or severity of adverse effects can be increased when Fluorouracil is combined with Natalizumab.Approved
G17DTThe therapeutic efficacy of G17DT can be decreased when used in combination with Natalizumab.Investigational
Gallium nitrateThe risk or severity of adverse effects can be increased when Gallium nitrate is combined with Natalizumab.Approved, Investigational
GemcitabineThe risk or severity of adverse effects can be increased when Gemcitabine is combined with Natalizumab.Approved
Gemtuzumab ozogamicinThe risk or severity of adverse effects can be increased when Gemtuzumab ozogamicin is combined with Natalizumab.Approved
GI-5005The therapeutic efficacy of GI-5005 can be decreased when used in combination with Natalizumab.Investigational
Glatiramer AcetateThe risk or severity of adverse effects can be increased when Glatiramer Acetate is combined with Natalizumab.Approved, Investigational
GlimepirideThe risk or severity of adverse effects can be increased when Glimepiride is combined with Natalizumab.Approved
GolimumabThe risk or severity of adverse effects can be increased when Golimumab is combined with Natalizumab.Approved
GS 0573The risk or severity of adverse effects can be increased when GS 0573 is combined with Natalizumab.Investigational
GusperimusThe risk or severity of adverse effects can be increased when Gusperimus is combined with Natalizumab.Investigational
Hepatitis A VaccineThe therapeutic efficacy of Hepatitis A Vaccine can be decreased when used in combination with Natalizumab.Approved
Hepatitis B Vaccine (Recombinant)The therapeutic efficacy of Hepatitis B Vaccine (Recombinant) can be decreased when used in combination with Natalizumab.Approved, Withdrawn
Human C1-esterase inhibitorThe risk or severity of adverse effects can be increased when Human C1-esterase inhibitor is combined with Natalizumab.Approved
HydrocortisoneThe risk or severity of adverse effects can be increased when Hydrocortisone is combined with Natalizumab.Approved, Vet Approved
HydroxyureaThe risk or severity of adverse effects can be increased when Hydroxyurea is combined with Natalizumab.Approved
HypericinThe risk or severity of adverse effects can be increased when Hypericin is combined with Natalizumab.Investigational
Ibritumomab tiuxetanThe risk or severity of adverse effects can be increased when Ibritumomab tiuxetan is combined with Natalizumab.Approved
IbrutinibThe risk or severity of adverse effects can be increased when Ibrutinib is combined with Natalizumab.Approved
IcatibantThe risk or severity of adverse effects can be increased when Icatibant is combined with Natalizumab.Approved
IdarubicinThe risk or severity of adverse effects can be increased when Idarubicin is combined with Natalizumab.Approved
IdelalisibThe risk or severity of adverse effects can be increased when Idelalisib is combined with Natalizumab.Approved
IfosfamideThe risk or severity of adverse effects can be increased when Ifosfamide is combined with Natalizumab.Approved
ImatinibThe risk or severity of adverse effects can be increased when Imatinib is combined with Natalizumab.Approved
ImiquimodThe risk or severity of adverse effects can be increased when Imiquimod is combined with Natalizumab.Approved, Investigational
InfliximabThe risk or severity of adverse effects can be increased when Infliximab is combined with Natalizumab.Approved
INGN 201The therapeutic efficacy of INGN 201 can be decreased when used in combination with Natalizumab.Investigational
INGN 225The therapeutic efficacy of INGN 225 can be decreased when used in combination with Natalizumab.Investigational
IrinotecanThe risk or severity of adverse effects can be increased when Irinotecan is combined with Natalizumab.Approved, Investigational
L-PhenylalanineThe risk or severity of adverse effects can be increased when L-Phenylalanine is combined with Natalizumab.Approved, Nutraceutical
LeflunomideThe risk or severity of adverse effects can be increased when Natalizumab is combined with Leflunomide.Approved, Investigational
LenalidomideThe risk or severity of adverse effects can be increased when Lenalidomide is combined with Natalizumab.Approved
LisofyllineThe risk or severity of adverse effects can be increased when Lisofylline is combined with Natalizumab.Investigational
LomustineThe risk or severity of adverse effects can be increased when Lomustine is combined with Natalizumab.Approved
MechlorethamineThe risk or severity of adverse effects can be increased when Mechlorethamine is combined with Natalizumab.Approved
MelphalanThe risk or severity of adverse effects can be increased when Melphalan is combined with Natalizumab.Approved
MepolizumabThe risk or severity of adverse effects can be increased when Mepolizumab is combined with Natalizumab.Approved, Investigational
MercaptopurineThe risk or severity of adverse effects can be increased when Mercaptopurine is combined with Natalizumab.Approved
MethotrexateThe risk or severity of adverse effects can be increased when Methotrexate is combined with Natalizumab.Approved
MethylprednisoloneThe risk or severity of adverse effects can be increased when Methylprednisolone is combined with Natalizumab.Approved, Vet Approved
MitomycinThe risk or severity of adverse effects can be increased when Mitomycin is combined with Natalizumab.Approved
MitoxantroneThe risk or severity of adverse effects can be increased when Mitoxantrone is combined with Natalizumab.Approved, Investigational
MizoribineThe risk or severity of adverse effects can be increased when Mizoribine is combined with Natalizumab.Investigational
MuromonabThe risk or severity of adverse effects can be increased when Muromonab is combined with Natalizumab.Approved, Investigational
Mycophenolate mofetilThe risk or severity of adverse effects can be increased when Mycophenolate mofetil is combined with Natalizumab.Approved, Investigational
Mycophenolic acidThe risk or severity of adverse effects can be increased when Mycophenolic acid is combined with Natalizumab.Approved
NafamostatThe risk or severity of adverse effects can be increased when Nafamostat is combined with Natalizumab.Approved, Investigational
NelarabineThe risk or severity of adverse effects can be increased when Nelarabine is combined with Natalizumab.Approved, Investigational
NilotinibThe risk or severity of adverse effects can be increased when Nilotinib is combined with Natalizumab.Approved, Investigational
ObinutuzumabThe risk or severity of adverse effects can be increased when Obinutuzumab is combined with Natalizumab.Approved
OxaliplatinThe risk or severity of adverse effects can be increased when Oxaliplatin is combined with Natalizumab.Approved, Investigational
PaclitaxelThe risk or severity of adverse effects can be increased when Paclitaxel is combined with Natalizumab.Approved, Vet Approved
PalbociclibThe risk or severity of adverse effects can be increased when Palbociclib is combined with Natalizumab.Approved
PanobinostatThe risk or severity of adverse effects can be increased when Panobinostat is combined with Natalizumab.Approved, Investigational
PaquinimodThe risk or severity of adverse effects can be increased when Paquinimod is combined with Natalizumab.Investigational
PazopanibThe risk or severity of adverse effects can be increased when Pazopanib is combined with Natalizumab.Approved
PegaspargaseThe risk or severity of adverse effects can be increased when Pegaspargase is combined with Natalizumab.Approved, Investigational
PemetrexedThe risk or severity of adverse effects can be increased when Pemetrexed is combined with Natalizumab.Approved, Investigational
PentostatinThe risk or severity of adverse effects can be increased when Pentostatin is combined with Natalizumab.Approved, Investigational
PimecrolimusThe risk or severity of adverse effects can be increased when Pimecrolimus is combined with Natalizumab.Approved, Investigational
PirarubicinThe risk or severity of adverse effects can be increased when Pirarubicin is combined with Natalizumab.Investigational
PirfenidoneThe risk or severity of adverse effects can be increased when Pirfenidone is combined with Natalizumab.Approved, Investigational
PomalidomideThe risk or severity of adverse effects can be increased when Pomalidomide is combined with Natalizumab.Approved
PralatrexateThe risk or severity of adverse effects can be increased when Pralatrexate is combined with Natalizumab.Approved
PrednisoloneThe risk or severity of adverse effects can be increased when Prednisolone is combined with Natalizumab.Approved, Vet Approved
PrednisoneThe risk or severity of adverse effects can be increased when Prednisone is combined with Natalizumab.Approved, Vet Approved
ProcarbazineThe risk or severity of adverse effects can be increased when Procarbazine is combined with Natalizumab.Approved
Rabies virus inactivated antigen, AThe therapeutic efficacy of Rabies virus inactivated antigen, A can be decreased when used in combination with Natalizumab.Approved
RilonaceptThe risk or severity of adverse effects can be increased when Rilonacept is combined with Natalizumab.Approved
RindopepimutThe therapeutic efficacy of Rindopepimut can be decreased when used in combination with Natalizumab.Investigational
RituximabThe risk or severity of adverse effects can be increased when Rituximab is combined with Natalizumab.Approved
RoflumilastRoflumilast may increase the immunosuppressive activities of Natalizumab.Approved
Rotavirus VaccineThe therapeutic efficacy of Rotavirus Vaccine can be decreased when used in combination with Natalizumab.Approved
Rubella virus vaccineThe therapeutic efficacy of Rubella virus vaccine can be decreased when used in combination with Natalizumab.Approved
RuxolitinibThe risk or severity of adverse effects can be increased when Ruxolitinib is combined with Natalizumab.Approved
Salmonella typhi ty21a live antigenThe therapeutic efficacy of Salmonella typhi ty21a live antigen can be decreased when used in combination with Natalizumab.Approved
SecukinumabThe risk or severity of adverse effects can be increased when Secukinumab is combined with Natalizumab.Approved
SemapimodThe risk or severity of adverse effects can be increased when Semapimod is combined with Natalizumab.Investigational
SeocalcitolThe risk or severity of adverse effects can be increased when Seocalcitol is combined with Natalizumab.Experimental, Investigational
SiltuximabThe risk or severity of adverse effects can be increased when Siltuximab is combined with Natalizumab.Approved
Sipuleucel-TThe therapeutic efficacy of Sipuleucel-T can be decreased when used in combination with Natalizumab.Approved
SirolimusThe risk or severity of adverse effects can be increased when Sirolimus is combined with Natalizumab.Approved, Investigational
SorafenibThe risk or severity of adverse effects can be increased when Sorafenib is combined with Natalizumab.Approved, Investigational
SRP 299The therapeutic efficacy of SRP 299 can be decreased when used in combination with Natalizumab.Investigational
SteproninThe risk or severity of adverse effects can be increased when Stepronin is combined with Natalizumab.Approved
StreptozocinThe risk or severity of adverse effects can be increased when Streptozocin is combined with Natalizumab.Approved
SunitinibThe risk or severity of adverse effects can be increased when Sunitinib is combined with Natalizumab.Approved, Investigational
TacrolimusThe risk or severity of adverse effects can be increased when Tacrolimus is combined with Natalizumab.Approved, Investigational
TecemotideThe therapeutic efficacy of Tecemotide can be decreased when used in combination with Natalizumab.Investigational
TemozolomideThe risk or severity of adverse effects can be increased when Temozolomide is combined with Natalizumab.Approved, Investigational
TemsirolimusThe risk or severity of adverse effects can be increased when Temsirolimus is combined with Natalizumab.Approved
TeniposideThe risk or severity of adverse effects can be increased when Teniposide is combined with Natalizumab.Approved
TepoxalinThe risk or severity of adverse effects can be increased when Tepoxalin is combined with Natalizumab.Vet Approved
TeriflunomideThe risk or severity of adverse effects can be increased when Teriflunomide is combined with Natalizumab.Approved
TG4010The therapeutic efficacy of TG4010 can be decreased when used in combination with Natalizumab.Investigational
ThalidomideThe risk or severity of adverse effects can be increased when Thalidomide is combined with Natalizumab.Approved, Investigational, Withdrawn
ThiotepaThe risk or severity of adverse effects can be increased when Thiotepa is combined with Natalizumab.Approved
TioguanineThe risk or severity of adverse effects can be increased when Tioguanine is combined with Natalizumab.Approved
TocilizumabThe risk or severity of adverse effects can be increased when Tocilizumab is combined with Natalizumab.Approved
TofacitinibThe risk or severity of adverse effects can be increased when Tofacitinib is combined with Natalizumab.Approved, Investigational
TopotecanThe risk or severity of adverse effects can be increased when Topotecan is combined with Natalizumab.Approved, Investigational
TositumomabThe risk or severity of adverse effects can be increased when Tositumomab is combined with Natalizumab.Approved, Investigational
TrabectedinThe risk or severity of adverse effects can be increased when Trabectedin is combined with Natalizumab.Approved, Investigational
TrastuzumabTrastuzumab may increase the neutropenic activities of Natalizumab.Approved, Investigational
Trastuzumab emtansineThe risk or severity of adverse effects can be increased when Trastuzumab emtansine is combined with Natalizumab.Approved
TretinoinThe risk or severity of adverse effects can be increased when Tretinoin is combined with Natalizumab.Approved, Investigational, Nutraceutical
TriamcinoloneThe risk or severity of adverse effects can be increased when Triamcinolone is combined with Natalizumab.Approved, Vet Approved
TriptolideThe risk or severity of adverse effects can be increased when Triptolide is combined with Natalizumab.Investigational
TrofosfamideThe risk or severity of adverse effects can be increased when Trofosfamide is combined with Natalizumab.Investigational
UstekinumabThe risk or severity of adverse effects can be increased when Ustekinumab is combined with Natalizumab.Approved, Investigational
VedolizumabThe risk or severity of adverse effects can be increased when Vedolizumab is combined with Natalizumab.Approved
VilanterolThe risk or severity of adverse effects can be increased when Vilanterol is combined with Natalizumab.Approved
VinblastineThe risk or severity of adverse effects can be increased when Vinblastine is combined with Natalizumab.Approved
VincristineThe risk or severity of adverse effects can be increased when Vincristine is combined with Natalizumab.Approved, Investigational
VindesineThe risk or severity of adverse effects can be increased when Vindesine is combined with Natalizumab.Approved, Investigational
VinorelbineThe risk or severity of adverse effects can be increased when Vinorelbine is combined with Natalizumab.Approved, Investigational
VoclosporinThe risk or severity of adverse effects can be increased when Voclosporin is combined with Natalizumab.Investigational
Yellow fever vaccineThe therapeutic efficacy of Yellow fever vaccine can be decreased when used in combination with Natalizumab.Approved
Zoster vaccineThe therapeutic efficacy of Zoster vaccine can be decreased when used in combination with Natalizumab.Approved
Food Interactions
Not Available

References

General References
  1. Ghosh S, Goldin E, Gordon FH, Malchow HA, Rask-Madsen J, Rutgeerts P, Vyhnalek P, Zadorova Z, Palmer T, Donoghue S: Natalizumab for active Crohn's disease. N Engl J Med. 2003 Jan 2;348(1):24-32. [PubMed:12510039]
External Links
PubChem Substance
46505849
ChEMBL
CHEMBL1201607
Therapeutic Targets Database
DAP001094
PharmGKB
PA164747191
RxList
RxList Drug Page
Drugs.com
Drugs.com Drug Page
Wikipedia
Natalizumab
ATC Codes
L04AA23 — Natalizumab
AHFS Codes
  • 92:20.00 — Immunomodulatory Agents
FDA label
Download (96 KB)

Clinical Trials

Clinical Trials
PhaseStatusPurposeConditionsCount
0CompletedTreatmentRelapsing Forms of Multiple Sclerosis1
1Active Not RecruitingBasic ScienceSchizophrenic Disorders1
1Active Not RecruitingTreatmentInclusion Body Myositis (IBM)1
1CompletedTreatmentRelapsing Remitting Multiple Sclerosis (RRMS)1
1CompletedTreatmentRelapsing Remitting Multiple Sclerosis (RRMS) / Secondary Progressive Multiple Sclerosis (SPMS)1
1, 2TerminatedTreatmentMultiple Myeloma (MM)1
2Active Not RecruitingTreatmentAcute Ischemic Stroke (AIS)1
2CompletedNot AvailableDisseminated Sclerosis1
2CompletedTreatmentAcute Ischemic Stroke (AIS)1
2CompletedTreatmentCrohn's Disease (CD)2
2CompletedTreatmentDisseminated Sclerosis / Relapsing Remitting Multiple Sclerosis (RRMS)1
2CompletedTreatmentMultiple Sclerosis, Primary Progressive / Secondary Progressive Multiple Sclerosis (SPMS)1
2CompletedTreatmentRelapsing Remitting Multiple Sclerosis (RRMS)3
2Not Yet RecruitingTreatmentEpilepsy, Focal Seizures, Partial Seizures1
2RecruitingTreatmentAcute Graft Versus Host Disease1
2RecruitingTreatmentGraft Versus Host Disease (GVHD)1
2TerminatedTreatmentRelapsing Multiple Sclerosis (RMS)1
2TerminatedTreatmentRheumatoid Arthritis2
2, 3CompletedTreatmentDisseminated Sclerosis1
2, 3RecruitingTreatmentDisseminated Sclerosis / Relapsing Remitting Multiple Sclerosis (RRMS)1
3CompletedTreatmentCrohn's Disease (CD)3
3CompletedTreatmentDisseminated Sclerosis1
3CompletedTreatmentRelapsing Remitting Multiple Sclerosis (RRMS)3
3TerminatedNot AvailableRelapsing Remitting Multiple Sclerosis (RRMS)1
3TerminatedTreatmentRelapsing Remitting Multiple Sclerosis (RRMS)1
3TerminatedTreatmentSecondary Progressive Multiple Sclerosis (SPMS)1
4CompletedNot AvailableCrohn's Disease (CD)1
4CompletedNot AvailableDisseminated Sclerosis1
4CompletedBasic ScienceDisseminated Sclerosis1
4CompletedDiagnosticDisseminated Sclerosis1
4CompletedSupportive CareRelapsing Remitting Multiple Sclerosis (RRMS)1
4CompletedTreatmentRelapsing Remitting Multiple Sclerosis (RRMS)3
4RecruitingOtherDisseminated Sclerosis1
4RecruitingTreatmentDisseminated Sclerosis1
4TerminatedTreatmentRelapsing Multiple Sclerosis (RMS)1
4TerminatedTreatmentRelapsing Remitting Multiple Sclerosis (RRMS)1
4Unknown StatusTreatmentRelapsing Remitting Multiple Sclerosis (RRMS)1
4WithdrawnTreatmentCrohn's Disease (CD)1
4WithdrawnTreatmentRelapsing Remitting Multiple Sclerosis (RRMS)1
Not AvailableActive Not RecruitingNot AvailableDisseminated Sclerosis1
Not AvailableActive Not RecruitingNot AvailableRelapsing Remitting Multiple Sclerosis (RRMS)3
Not AvailableCompletedNot AvailableDisseminated Sclerosis3
Not AvailableCompletedNot AvailableRelapsing Multiple Sclerosis (RMS)1
Not AvailableCompletedNot AvailableRelapsing Remitting Multiple Sclerosis (RRMS)2
Not AvailableCompletedSupportive CareDisseminated Sclerosis1
Not AvailableCompletedTreatmentDisseminated Sclerosis1
Not AvailableRecruitingNot AvailableRelapsing Remitting Multiple Sclerosis (RRMS)2
Not AvailableTerminatedNot AvailableCrohn's Disease (CD)1

Pharmacoeconomics

Manufacturers
Not Available
Packagers
Dosage forms
FormRouteStrength
InjectionIntravenous300 mg/15mL
SolutionIntravenous300 mg
Prices
Unit descriptionCostUnit
Tysabri 300 mg/15 ml vial207.31USD ml
DrugBank does not sell nor buy drugs. Pricing information is supplied for informational purposes only.
Patents
Not Available

Properties

State
Liquid
Experimental Properties
PropertyValueSource
melting point (°C)61 °C (FAB fragment), 71 °C (whole mAb)Vermeer, A.W.P. & Norde, W., Biophys. J. 78:394-404 (2000)

Taxonomy

Description
Not Available
Kingdom
Organic Compounds
Super Class
Organic Acids
Class
Carboxylic Acids and Derivatives
Sub Class
Amino Acids, Peptides, and Analogues
Direct Parent
Peptides
Alternative Parents
Not Available
Substituents
Not Available
Molecular Framework
Not Available
External Descriptors
Not Available

Targets

Kind
Protein
Organism
Human
Pharmacological action
Yes
Actions
Antibody
General Function
Metal ion binding
Specific Function
Integrins alpha-4/beta-1 (VLA-4) and alpha-4/beta-7 are receptors for fibronectin. They recognize one or more domains within the alternatively spliced CS-1 and CS-5 regions of fibronectin. They are...
Gene Name
ITGA4
Uniprot ID
P13612
Uniprot Name
Integrin alpha-4
Molecular Weight
114898.745 Da
References
  1. Sheremata WA, Minagar A, Alexander JS, Vollmer T: The role of alpha-4 integrin in the aetiology of multiple sclerosis: current knowledge and therapeutic implications. CNS Drugs. 2005;19(11):909-22. [PubMed:16268663]
  2. Niino M, Bodner C, Simard ML, Alatab S, Gano D, Kim HJ, Trigueiro M, Racicot D, Guerette C, Antel JP, Fournier A, Grand'Maison F, Bar-Or A: Natalizumab effects on immune cell responses in multiple sclerosis. Ann Neurol. 2006 May;59(5):748-54. [PubMed:16634035]
  3. Stuve O, Bennett JL: Pharmacological properties, toxicology and scientific rationale for the use of natalizumab (Tysabri) in inflammatory diseases. CNS Drug Rev. 2007 Spring;13(1):79-95. [PubMed:17461891]
  4. Craddock CF, Nakamoto B, Andrews RG, Priestley GV, Papayannopoulou T: Antibodies to VLA4 integrin mobilize long-term repopulating cells and augment cytokine-induced mobilization in primates and mice. Blood. 1997 Dec 15;90(12):4779-88. [PubMed:9389694]
  5. Chen X, Ji ZL, Chen YZ: TTD: Therapeutic Target Database. Nucleic Acids Res. 2002 Jan 1;30(1):412-5. [PubMed:11752352]
Kind
Protein
Organism
Human
Pharmacological action
Unknown
General Function
Not Available
Specific Function
Receptor for the Fc region of immunoglobulins gamma. Low affinity receptor. Binds complexed or aggregated IgG and also monomeric IgG. Contrary to III-A, is not capable to mediate antibody-dependent...
Gene Name
FCGR3B
Uniprot ID
O75015
Uniprot Name
Low affinity immunoglobulin gamma Fc region receptor III-B
Molecular Weight
26215.64 Da
References
  1. Overington JP, Al-Lazikani B, Hopkins AL: How many drug targets are there? Nat Rev Drug Discov. 2006 Dec;5(12):993-6. [PubMed:17139284]
  2. Imming P, Sinning C, Meyer A: Drugs, their targets and the nature and number of drug targets. Nat Rev Drug Discov. 2006 Oct;5(10):821-34. [PubMed:17016423]
Kind
Protein
Organism
Human
Pharmacological action
Unknown
General Function
Serine-type peptidase activity
Specific Function
C1r B chain is a serine protease that combines with C1q and C1s to form C1, the first component of the classical pathway of the complement system.
Gene Name
C1R
Uniprot ID
P00736
Uniprot Name
Complement C1r subcomponent
Molecular Weight
80118.04 Da
References
  1. Overington JP, Al-Lazikani B, Hopkins AL: How many drug targets are there? Nat Rev Drug Discov. 2006 Dec;5(12):993-6. [PubMed:17139284]
  2. Imming P, Sinning C, Meyer A: Drugs, their targets and the nature and number of drug targets. Nat Rev Drug Discov. 2006 Oct;5(10):821-34. [PubMed:17016423]
Kind
Protein
Organism
Human
Pharmacological action
Unknown
General Function
Not Available
Specific Function
C1q associates with the proenzymes C1r and C1s to yield C1, the first component of the serum complement system. The collagen-like regions of C1q interact with the Ca(2+)-dependent C1r(2)C1s(2) proe...
Gene Name
C1QA
Uniprot ID
P02745
Uniprot Name
Complement C1q subcomponent subunit A
Molecular Weight
26016.47 Da
References
  1. Overington JP, Al-Lazikani B, Hopkins AL: How many drug targets are there? Nat Rev Drug Discov. 2006 Dec;5(12):993-6. [PubMed:17139284]
  2. Imming P, Sinning C, Meyer A: Drugs, their targets and the nature and number of drug targets. Nat Rev Drug Discov. 2006 Oct;5(10):821-34. [PubMed:17016423]
Kind
Protein
Organism
Human
Pharmacological action
Unknown
General Function
Not Available
Specific Function
C1q associates with the proenzymes C1r and C1s to yield C1, the first component of the serum complement system. The collagen-like regions of C1q interact with the Ca(2+)-dependent C1r(2)C1s(2) proe...
Gene Name
C1QB
Uniprot ID
P02746
Uniprot Name
Complement C1q subcomponent subunit B
Molecular Weight
26721.62 Da
References
  1. Overington JP, Al-Lazikani B, Hopkins AL: How many drug targets are there? Nat Rev Drug Discov. 2006 Dec;5(12):993-6. [PubMed:17139284]
  2. Imming P, Sinning C, Meyer A: Drugs, their targets and the nature and number of drug targets. Nat Rev Drug Discov. 2006 Oct;5(10):821-34. [PubMed:17016423]
Kind
Protein
Organism
Human
Pharmacological action
Unknown
General Function
Not Available
Specific Function
C1q associates with the proenzymes C1r and C1s to yield C1, the first component of the serum complement system. The collagen-like regions of C1q interact with the Ca(2+)-dependent C1r(2)C1s(2) proe...
Gene Name
C1QC
Uniprot ID
P02747
Uniprot Name
Complement C1q subcomponent subunit C
Molecular Weight
25773.56 Da
References
  1. Overington JP, Al-Lazikani B, Hopkins AL: How many drug targets are there? Nat Rev Drug Discov. 2006 Dec;5(12):993-6. [PubMed:17139284]
  2. Imming P, Sinning C, Meyer A: Drugs, their targets and the nature and number of drug targets. Nat Rev Drug Discov. 2006 Oct;5(10):821-34. [PubMed:17016423]
Kind
Protein
Organism
Human
Pharmacological action
Unknown
General Function
Not Available
Specific Function
Receptor for the Fc region of IgG. Binds complexed or aggregated IgG and also monomeric IgG. Mediates antibody-dependent cellular cytotoxicity (ADCC) and other antibody-dependent responses, such as...
Gene Name
FCGR3A
Uniprot ID
P08637
Uniprot Name
Low affinity immunoglobulin gamma Fc region receptor III-A
Molecular Weight
29088.895 Da
References
  1. Overington JP, Al-Lazikani B, Hopkins AL: How many drug targets are there? Nat Rev Drug Discov. 2006 Dec;5(12):993-6. [PubMed:17139284]
  2. Imming P, Sinning C, Meyer A: Drugs, their targets and the nature and number of drug targets. Nat Rev Drug Discov. 2006 Oct;5(10):821-34. [PubMed:17016423]
Kind
Protein
Organism
Human
Pharmacological action
Unknown
General Function
Receptor signaling protein activity
Specific Function
High affinity receptor for the Fc region of immunoglobulins gamma. Functions in both innate and adaptive immune responses.
Gene Name
FCGR1A
Uniprot ID
P12314
Uniprot Name
High affinity immunoglobulin gamma Fc receptor I
Molecular Weight
42631.525 Da
References
  1. Overington JP, Al-Lazikani B, Hopkins AL: How many drug targets are there? Nat Rev Drug Discov. 2006 Dec;5(12):993-6. [PubMed:17139284]
  2. Imming P, Sinning C, Meyer A: Drugs, their targets and the nature and number of drug targets. Nat Rev Drug Discov. 2006 Oct;5(10):821-34. [PubMed:17016423]
Kind
Protein
Organism
Human
Pharmacological action
Unknown
General Function
Not Available
Specific Function
Binds to the Fc region of immunoglobulins gamma. Low affinity receptor. By binding to IgG it initiates cellular responses against pathogens and soluble antigens. Promotes phagocytosis of opsonized ...
Gene Name
FCGR2A
Uniprot ID
P12318
Uniprot Name
Low affinity immunoglobulin gamma Fc region receptor II-a
Molecular Weight
35000.42 Da
References
  1. Overington JP, Al-Lazikani B, Hopkins AL: How many drug targets are there? Nat Rev Drug Discov. 2006 Dec;5(12):993-6. [PubMed:17139284]
  2. Imming P, Sinning C, Meyer A: Drugs, their targets and the nature and number of drug targets. Nat Rev Drug Discov. 2006 Oct;5(10):821-34. [PubMed:17016423]
Kind
Protein
Organism
Human
Pharmacological action
Unknown
General Function
Not Available
Specific Function
Receptor for the Fc region of complexed or aggregated immunoglobulins gamma. Low affinity receptor. Involved in a variety of effector and regulatory functions such as phagocytosis of immune complex...
Gene Name
FCGR2B
Uniprot ID
P31994
Uniprot Name
Low affinity immunoglobulin gamma Fc region receptor II-b
Molecular Weight
34043.355 Da
References
  1. Overington JP, Al-Lazikani B, Hopkins AL: How many drug targets are there? Nat Rev Drug Discov. 2006 Dec;5(12):993-6. [PubMed:17139284]
  2. Imming P, Sinning C, Meyer A: Drugs, their targets and the nature and number of drug targets. Nat Rev Drug Discov. 2006 Oct;5(10):821-34. [PubMed:17016423]
Kind
Protein
Organism
Human
Pharmacological action
Unknown
General Function
Transmembrane signaling receptor activity
Specific Function
Receptor for the Fc region of complexed immunoglobulins gamma. Low affinity receptor. Involved in a variety of effector and regulatory functions such as phagocytosis of immune complexes and modulat...
Gene Name
FCGR2C
Uniprot ID
P31995
Uniprot Name
Low affinity immunoglobulin gamma Fc region receptor II-c
Molecular Weight
35577.96 Da
References
  1. Overington JP, Al-Lazikani B, Hopkins AL: How many drug targets are there? Nat Rev Drug Discov. 2006 Dec;5(12):993-6. [PubMed:17139284]
  2. Imming P, Sinning C, Meyer A: Drugs, their targets and the nature and number of drug targets. Nat Rev Drug Discov. 2006 Oct;5(10):821-34. [PubMed:17016423]
Kind
Protein
Organism
Human
Pharmacological action
Unknown
General Function
Virus receptor activity
Specific Function
ICAM proteins are ligands for the leukocyte adhesion protein LFA-1 (integrin alpha-L/beta-2). During leukocyte trans-endothelial migration, ICAM1 engagement promotes the assembly of endothelial api...
Gene Name
ICAM1
Uniprot ID
P05362
Uniprot Name
Intercellular adhesion molecule 1
Molecular Weight
57824.785 Da
References
  1. Chen X, Ji ZL, Chen YZ: TTD: Therapeutic Target Database. Nucleic Acids Res. 2002 Jan 1;30(1):412-5. [PubMed:11752352]

Drug created on June 13, 2005 07:24 / Updated on November 19, 2017 20:34