Natalizumab (Tysabri)
EVICORE-MEDICAL_DRUG-D1EE6A65
Covers natalizumab (Tysabri) for FDA‑approved relapsing multiple sclerosis and moderately‑to‑severely active Crohn’s disease with inflammation, and excludes patients who are anti‑JCV antibody positive, under 18, or receiving concurrent immunosuppressants or TNF‑inhibitors. Key requirements: age ≥18, documented JCV negativity, MS use as monotherapy; Crohn’s requires failure of ≥2 conventional therapies plus ≥1 TNF‑inhibitor, clinical benefit by 12 weeks and corticosteroid taper for reauthorization, enrollment in the TOUCH program, and ongoing monitoring with withholding/discontinuation for PML, liver injury, or opportunistic infections.
"Multiple Sclerosis"
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