Natalizumab is typically given as 300mg intravenous infusion every month, as the patent life of natalizumab expired a new route was developed and that is subcutaneous or under the skin. It is whacked in a lot quicker and may be delivered at home. This saves the UK PLC money as home delivery does not attract Value Added Tax (sales Tax) which is currently 20%. This study says it is preferred…in the trials it says this route didn’t cause anti-drug antibodies which needs some explanation. We will explain this later.
ProfK will be using the infusion in AttackMS; maybe in the future they can offer subcutaneous delivery [ProfK here: That would be a logical next step, although in the hyperacute setting of AttackMS, IV is IMO the way to go. Mind you, getting a vial of natalizumab in *any* shape or formulation into an emergency room would be a leap forward].
Almroth A, Söderbärg K, Sjöblom I. Patient Preference and Time Allocation Associated with Transition from Intravenous to Subcutaneous Administration of Natalizumab (Tysabri) in Patients with Relapsing Remitting MS – A Questionnaire Study. Patient Prefer Adherence. 2025 Dec 23;19:4233-4244.
Introduction: Natalizumab (NTZ, Tysabri, Biogen) is an established treatment for highly active relapsing-remitting multiple sclerosis (RRMS), administered either intravenously (IV) in hospital settings or subcutaneously (SC), the latter of which can be administered in primary care. This study investigated self-reported preferences, satisfaction, and time allocation of patients and healthcare professionals (HCPs).
Methods: A total of 83 patients with RRMS and 14 HCPs participated and completed questionnaires across five Swedish hospitals. Participants had experience with both NTZ IV and SC administration, and data collection focused on time efficiency, impact on daily activities, satisfaction, and the ease of transitioning to SC.
Results: SC administration was reported as more time-efficient, with 72% of patients spending ≤30 min at the hospital vs 83% reporting 1-2 h for IV. In primary care, 75% of patients reported that SC treatments required less than 15 minutes. The setting of the SC administration had an effect on work disruption according to patients; 60% of patients in primary care reported no impact on work, compared to 35% for SC treatments in hospitals. Regarding preference, 80% of patients favoured SC over IV. Among patients offered SC in primary care, 75% preferred it over hospital treatment. HCPs reported shorter preparation times and improved workflow efficiency with SC, with 93% completing SC treatments within 30 minutes. Both patients and HCPs found the transition from IV to SC manageable, and 86% of HCPs expressed confidence in their ability to inform patients about SC administration.
Discussion: The results align with previous studies, showing SC NTZ provides time savings, less disruption to daily life, and high satisfaction for patients and HCPs. Its feasibility in primary care supports broader adoption, with implications for improving healthcare resource allocation and patient adherence. Future research should focus on long-term outcomes and global implementation.
Source: multiple-sclerosis-research.org