Improved cognition and depression in patients with MS after two years of treatment with Natalizumab (P3.275)

OBJECTIVE/BACKGROUND: Positive treatment effects have been shown with Natalizumab in relapsing-remitting MS (RRMS) on physical disabilities, relapse rate and MRI detectable disease activity. Whereas cognitive deficits are common in MS (40-80[percnt]) only little is known about the effect of Natalizumab on cognition and depression. Therefore the present retrospective open label observational study investigates the effect of Natalizumab on attention and depression over a treatment period of two years. DESIGN/METHODS: 51 patients with RRMS (male = 11, female = 40; mean age: 33.9+9.1 years) underwent a comprehensive neuropsychological assessment, consisting of different tests of attention (SDMT; Attention test battery: alertness, divided attention, flexibility), depression (CES-D) and fatigue (FSMC). The assessments are performed immediately before the first administration of Natalizumab, and again after one and two years of treatment. RESULTS: Significant improvements were found in 3 out of 10 attention parameters after one year of treatment (SDMT: p = 0.02; alertness: reaction time (RT) cued, p = 0.02; divided attention: visual RT, p = 0.02) and in 5 out of 10 parameters in the second year of treatment (SDMT: p = 0.01; divided attention: visual RT: p = 0.000; errors, p = 0.01, omissions, p = 0.05; flexibility: RT, p = 0.05). The CES-D value decreased significantly in the first year from 29.41[percnt] of patients with depression to 21.56[percnt] (p = 0.047) and in the second year to 22.58[percnt] (p = 0.02) No effects were detected on fatigue. CONCLUSIONS:Our observational study has been able to show positive effects on attention parameters in patients with RRMS and, for the first time, reduced depression two years after treatment with Natalizumab. Study Supported by: Disclosure: Dr. Kunkel has nothing to disclose. Dr. Faiss has received personal compensation for activities with Biogen Idec, Schering, and Boehringer Ingelheim as a speaker. Dr. Koehler has received personal compensation for activities with Merck & Co. Inc., Bayer Pharmaceuticals Corp., Biogen Idec, Novartis, Genzyme, and Sanofi. Dr. Fischer has nothing to disclose.