Natalizumab plus interferon beta-1a reduces lesion formation in relapsing multiple sclerosis

SENTINEL Investigators

Research output: Contribution to journalArticlepeer-review


The SENTINEL study showed that the addition of natalizumab improved outcomes for patients with relapsing multiple sclerosis (MS) who had experienced disease activity while receiving interferon beta-1a (IFNβ-1a) alone. Previously unreported secondary and tertiary magnetic resonance imaging (MRI) measures are presented here. Patients received natalizumab 300 mg (n = 589) or placebo (n = 582) intravenously every 4 weeks plus IFNβ-1a 30 μg intramuscularly once weekly. Annual MRI scans allowed comparison of a range of MRI end points versus baseline. Over 2 years, 67% of patients receiving natalizumab plus IFNβ-1a remained free of new or enlarging T2-lesions compared with 30% of patients receiving IFNβ-1a alone. The mean change from baseline in T2 lesion volume over 2 years decreased in patients receiving natalizumab plus IFNβ-1a and increased in those receiving IFNβ-1a alone (-277.5 mm3 versus 525.6 mm3; p < 0.001). Compared with IFNβ-1a alone, add-on natalizumab therapy resulted in a smaller increase in mean T1-hypointense lesion volume after 2 years (1821.3 mm3 versus 2210.5 mm3; p < 0.001), a smaller mean number of new T1-hypointense lesions over 2 years (2.3 versus 4.1; p < 0.001), and a slower rate of brain atrophy during the second year of therapy (-0.31% versus -0.40%; p = 0.020). Natalizumab add-on therapy reduced gadolinium-enhancing, T1-hypointense, and T2 MRI lesion activity and slowed brain atrophy progression in patients with relapsing MS who experienced disease activity despite treatment with IFNβ-1a alone.

Original languageEnglish (US)
Pages (from-to)28-35
Number of pages8
JournalJournal of the Neurological Sciences
Issue number1-2
StatePublished - May 15 2010


  • Adhesion molecule inhibitor
  • Integrin
  • Interferon beta-1a
  • Magnetic resonance imaging
  • Multiple sclerosis
  • Natalizumab
  • Treatment

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology


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