Natalizumab (branded or biosimilar) is recommended as an option for the treatment only of rapidly evolving severe relapsing–remitting multiple sclerosis (RES‑RRMS) in adults. RES‑RRMS is defined by 2 or more relapses in the previous year, and baseline MRI evidence of disease activity.
This recommendation is not intended to affect treatment with natalizumab that was started in the NHS before this guidance was published. People having treatment outside this recommendation may continue without change to the funding arrangements in place for them before this guidance was published, until they and their NHS healthcare professional consider it appropriate to stop.