Table 6.

Systematic review of anti-α4-integrin agents in epilepsy.

References	Disease	N, (age)	Study design	Intervention	Timing	Efficacy	Safety
French et al. (135)	DRE	32 [mean 42.8 years (±14.56)]	Randomized, placebo-controlled, double-blinded study	Natalizumab 300 mg IV every 4 weeks for 24 weeks	Start: not specified Stop: 24 weeks after the first dose.	Compared to placebo, the natalizumab-treated group showed a greater reduction in seizure frequency from baseline. 10/32 participants showed a reduction of ≥50% from baseline in seizure frequency during weeks 8–24. None of the participants remained free from seizures. One participant experienced an inadequate treatment response (e.g., did not modify ASMs after week 12 of the placebo-controlled period or did not discontinue the treatment after the active run-in period due to lack of efficacy)	24/32 participants experienced adverse effects ranging from mild (15/24), moderate (8/15) and severe (1/32). One participant experienced a serious event (urticaria) and discontinued the treatment.

ASM, anti-seizure medication; DRE, drug-resistant epilepsy; IV, intravenous.