Intravenous therapies
| Treatment | Dose/administration | FDA Approval | Common side effects |
|---|---|---|---|
| Natalizumab Tysabri | 300 mg IV once in 28 days | To reduce frequency of clinical exacerbations by 67% and long-term disability by 42% in RRMS As a second-line or third-line therapy, although sometimes used as a first-line therapy in very aggressive RRMS Approved 2006 Pregnancy category C | Headache, fatigue, joint pain, chest discomfort, UTI, lower respiratory tract infection, gastroenteritis, overall increase risk of infections PML Occasional increase in LFTs and decreased WCC, although rare |
| Alemtuzumab Lemtrada | 12 mg IV once daily ×5 days, then repeat 12 mg IV once daily ×3 days in 1 year | To reduce frequency of clinical exacerbations by 49% and reduce long-term disability by 42% in RRMS As a third-line therapy Approved 2014 Pregnancy category C | Rash, headache, fever, nasal congestion, nausea, UTI, fatigue, insomnia, URI, herpes viral infections, hives, itching, thyroid gland disorders (common), fungal Infection, pain in joints, extremities and back, diarrhea, vomiting, flushing. Infusion reactions Elevation of LFTs and decreased WCC Can cause other autoimmune disorders that can be fatal like Immune thrombocytopenia and increase risk of malignancies like melanoma, thyroid cancer and lymphoproliferative disorders |
DMT, disease-modifying therapy; FDA, Food and Drug Administration; IV, intravenous; LFTs, liver enzyme tests; RRMS, relapsing-remitting multiple sclerosis; PML, progressive multifocal leukoencephalopathy; URI, upper respiratory infections; UTI, urinary tract infection; WCC, white cell count.