fingolimod + natalizumab

Fingolimod + natalizumab is a combination of two disease-modifying therapies used in the treatment of relapsing-remitting multiple sclerosis (RRMS). Fingolimod is an oral small molecule that acts as a sphingosine-1-phosphate receptor modulator, preventing lymphocyte egress from lymph nodes and thereby reducing their migration into the central nervous system. Natalizumab is a monoclonal antibody targeting α4-integrin, blocking leukocyte adhesion and transmigration across the blood-brain barrier. Both drugs reduce inflammation and relapse rates in MS but have distinct mechanisms of action affecting immune cell trafficking. This combination does not represent an approved or standard therapy; rather, each drug is typically used individually as escalation therapy for RRMS patients who do not respond to first-line treatments[1][2][6]. There are significant safety concerns with combined immunosuppression, including increased risk of infections.