Real-World Data Suggests Relapse Reduction and Cost Benefits of Natalizumab in Diverse MS Populations

A large real-world study of over 3200 people with multiple sclerosis (PwMS) found that natalizumab may significantly reduce relapse rates across all racial and ethnic groups, supporting its broad effectiveness in diverse populations and highlighting its potential to mitigate disparities in MS care.

The retrospective analysis of the Komodo Health Claims Database included 632 Black, 382 Hispanic, 49 Asian, and 2181 White PwMS treated with natalizumab between 2017 and 2022. While baseline disease severity and relapse rates were higher among Black and Hispanic patients compared with White patients, all groups experienced statistically significant reductions in annualized relapse rate (ARR) after initiating natalizumab. ARR declined by 64% in Black patients, 75% in Hispanic patients, 89% in Asian patients, and 45% in White patients (P < 0.001 within groups). Hispanic patients demonstrated a significantly greater reduction in ARR compared to White patients (P = 0.028).

“NTZ was effective across racial/ethnic groups although not significantly different between groups,” researchers concluded. 

At 2 years, more than 84% of patients in each group remained relapse-free. Despite baseline disparities in disease burden, comorbidities, and insurance status—factors that may influence access and outcomes—natalizumab demonstrated consistent therapeutic benefit.

Health care utilization patterns revealed a significant reduction in MS-related inpatient encounters and associated costs across all groups after natalizumab initiation. Although total encounter rates did not change significantly, inpatient events—responsible for a disproportionate share of MS-related health care costs—declined. This translated into a statistically significant reduction in annualized MS-related costs for Black (−37%), Hispanic (−44%), Asian (−44%), and White (−16%) PwMS.

The study represents the largest race- and ethnicity-stratified analysis of natalizumab effectiveness to date. It confirms that “access to NTZ has the potential to reduce disparities in clinical outcomes” and supports the consideration of high-efficacy therapies early in the treatment course for all patients with MS, regardless of racial or ethnic background.

References
Blitz-Shabbir K, Banks AM, Garg H, et al. Real-world treatment outcomes in Black, Hispanic, Asian, and White patients with Multiple Sclerosis treated with natalizumab. Drugs Real World Outcomes. 2025;12:301–310. doi:10.1007/s40801-025-00495-w