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Data updated: Mar 10, 2026

TYRUKO

NATALIZUMAB-SZTN Integrin Receptor Antagonists
Immunology Approved 2023-08-24

TYRUKO (natalizumab-sztn) is an integrin receptor antagonist indicated for the treatment of relapsing forms of multiple sclerosis (MS) and moderately to severely active Crohn’s disease in adults. In MS, the drug is used as monotherapy for clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease, though clinicians must weigh its use against the risk of progressive multifocal leukoencephalopathy (PML). For Crohn’s disease, it is indicated for patients with evidence of inflammation who have had an inadequate response to or cannot tolerate conventional therapies and TNF-α inhibitors. When used for Crohn's disease, TYRUKO should not be administered in combination with other immunosuppressants or TNF-α inhibitors.

Source: FDA Label • Novartis • Integrin Receptor Antagonist

How TYRUKO Works

TYRUKO binds to the α4-subunit of α4β1 and α4β7 integrins expressed on the surface of most leukocytes, excluding neutrophils. This binding inhibits the adhesion of these leukocytes to their receptors, such as VCAM-1 on vascular endothelium and MAdCAM-1 in the gastrointestinal tract. By disrupting these molecular interactions, the drug prevents the migration of inflammatory cells across the endothelium into parenchymal tissues like the brain and gut. This blockade reduces the recruitment and inflammatory activity of activated immune cells in patients with multiple sclerosis and Crohn’s disease.

Source: FDA Label
1
Indication
--
Phase 3 Trials
2
Years on Market

Details

Status
Prescription
First Approved
2023-08-24
Routes
INJECTION
Dosage Forms
INJECTABLE

Companies

Active Ingredient: NATALIZUMAB-SZTN

TYRUKO Approval History

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What TYRUKO Treats

2 indications

TYRUKO is approved for 2 conditions since its original approval in 2023. These indications span multiple therapeutic areas including oncology, immunology, and more.

  • Multiple Sclerosis
  • Crohn's Disease
Source: FDA Label

TYRUKO Boxed Warning

PROGRESSIVE MULTIFOCAL LEUKOENCEPHALOPATHY Natalizumab products increase the risk of progressive multifocal leukoencephalopathy (PML), an opportunistic viral infection of the brain that usually leads to death or severe disability. Risk factors for the development of PML include the presence of anti-JCV antibodies, duration of therapy, and prior use of immunosuppressants. These factors should be considered in the context of expected benefit when initiating and continuing treatment with TYRUKO [se...

Biosimilar for Tysabri

TYRUKO is a lower-cost alternative to Tysabri with no clinically meaningful differences. Requires prescriber approval to substitute.

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Trial Timeline

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Understanding FDA Approval Types
Count Type What it means
- ORIG Original approval - drug first enters market
- SUPPL - Efficacy New indication (new disease/condition approved)
- SUPPL - Labeling Label text changes (warnings, dosing updates)
- SUPPL - Manufacturing Production changes (new facility)
- SUPPL - Chemistry Formulation changes (new dosage strength)

Green lines in the timeline show ORIG and Efficacy approvals - the clinically meaningful milestones.

TYRUKO FDA Label Details

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Indications & Usage

FDA Label (PDF)

TYRUKO is an integrin receptor antagonist indicated for treatment of: Multiple Sclerosis (MS) TYRUKO is indicated as monotherapy for the treatment of relapsing forms of multiple sclerosis, to include clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease, in adults. Natalizumab products increase the risk of PML [see Warnings and Precautions ] . When initiating and continuing treatment with TYRUKO, physicians should consider whether the expected benefit of TYRUKO is sufficient to offset this risk. Crohn's Disease (CD) • TYRUKO is indicated for induci...

⚠️ BOXED WARNING

WARNING: PROGRESSIVE MULTIFOCAL LEUKOENCEPHALOPATHY Natalizumab products increase the risk of progressive multifocal leukoencephalopathy (PML), an opportunistic viral infection of the brain that usually leads to death or severe disability. Risk factors for the development of PML include the presence...

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Data Sources

Data sourced from official FDA and NIH databases. Click links to verify on original sources.