Long-term management of natalizumab discontinuation in a large monocentric cohort of multiple sclerosis patients

Francesca Sangalli, Lucia Moiola, Laura Ferrè, Marta Radaelli, Valeria Barcella, Mariaemma Rodegher, Bruno Colombo, Filippo Martinelli Boneschi, Vittorio Martinelli, Giancarlo Comi

Research output: Contribution to journalArticlepeer-review

Abstract

Background Pivotal and post-marketing studies demonstrated the impressive efficacy and the good tolerability profile of natalizumab in Multiple Sclerosis patients. On the other hand long-term safety of natalizumab therapy is burdened by the risk of progressive multifocal leukoencephalopathy, especially in anti-JCV seropositive patients treated for more than two years. Some of these patients must stop the drug at the risk of disease reactivation. Objectives To evaluate the effects of natalizumab discontinuation in a monocentric cohort of multiple sclerosis patients followed for a mean time of 22.4 months. Methods One hundred and ten patients, who stopped therapy after at least 12 infusions, were followed with periodic clinical and magnetic resonance imaging evaluations. One hundred patients started either immunomodulant therapy (n=90) or fingolimod (n=10) while 10 remained without any drug. Results "Disease-activity free" patients were 25% at one year after discontinuation and annualized relapse rate significantly increased from 0.06 to 0.84 (p

Original languageEnglish
Pages (from-to)520-526
Number of pages7
JournalMultiple Sclerosis and Related Disorders
Volume3
Issue number4
DOIs
Publication statusPublished - 2014

Keywords

  • Discontinuation
  • Multiple sclerosis
  • Tysabri

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

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