Natalizumab is effective in multiple sclerosis patients switching from other disease modifying therapies in clinical practice(312 views) Lanzillo R, Bonavita S, Quarantelli M, Vacca G, Lus G, Amato L, Carotenuto A, Tedeschi G, Orefice G, Brescia Morra V
Keywords: Annualised Relapse Rate, Longitudinal Study, Multiple Sclerosis, Natalizumab, Treatment Failure, Beta1a Interferon, Glatiramer, Interferon Beta Serine, Adult, Article, Clinical Article, Contrast Enhancement, Disease Activity, Drug Substitution, Drug Withdrawal, Expanded Disability Status Scale, Female, Human, Neuroimaging, Nuclear Magnetic Resonance Imaging, Recurrence Risk, Retrospective Study, Antibodies, Monoclonal, Humanized, Brain, Disability Evaluation, Immunologic Factors, Kaplan-Meier Estimate, Outcome Assessment (health Care), Young Adult, Therapeutic Use, Drug Effects, Pathology, Drug Therapy,
Affiliations: *** IBB - CNR ***
Neurological Sciences Department, Federico II University, Via Pansini 5, 80131 Naples, Italy
Hermitage Capodimonte IDC, Naples, Italy
Department of Neurological Sciences, Second University of Naples, Naples, Italy
Diagnostic Imaging Department, Federico II University, Naples, Italy
Biostructure and Bioimaging Institute, National Research Council, Naples, Italy
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Natalizumab is effective in multiple sclerosis patients switching from other disease modifying therapies in clinical practice
Natalizumab is one option for multiple sclerosis patients responding poorly to classical immunomodulators, but pilot studies did not point to its effectiveness as a second-line therapy. Aim of this study was to assess the efficacy of natalizumab as second-line therapy in patients switching from disease modifying therapies (DMTs) in a clinical setting. We retrospectively selected patients who had been treated with natalizumab for at least 12 months after switching from one or more DMTs. We collected clinical and neuroradiological data and we analysed the reduction in annualised relapse rate (ARR), the change of Expanded Disability Status Scale (EDSS) and the reduction of contrast-enhancing lesions (CELs) at magnetic resonance imaging (MRI) of the brain at 12 months of natalizumab and of previous DMT therapy. Fifty patients were included in the analysis (11 males, 39 females). We observed a reduction of ARR on natalizumab (p = 0. 000) and a statistically significant different trend of relapse event between the two treatments (p = 0. 0149). EDSS was stable during natalizumab therapy whilst it showed an increase on DMTs (p = 0. 0244). The number of CELs decreased significantly (p = 0. 006) during the 12 months of treatment with natalizumab, whilst it was stable on DMTs. Natalizumab showed to decrease ARR, stabilize EDSS, increase the percentage of CELs free patients and decrease the number of CELs in a group of 50 poor responders to classical DMT, after the first 12 months of therapy. 2012 Springer-Verlag
Natalizumab is effective in multiple sclerosis patients switching from other disease modifying therapies in clinical practice