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Return to: GILENYA (fingolimod, FTY720) |
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#Post#: 1794-------------------------------------------------- |
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(Abst.) Switching from Tysabri to Gilenya within 6 weeks cuts re |
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currence of MS disease activity |
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By: agate Date: August 22, 2017, 9:52 am |
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From PubMed, August 22, 2017: |
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[quote]Mult Scler. 2017 Aug 1:1352458517726381. |
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Switching natalizumab to fingolimod within 6 weeks reduces |
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recurrence of disease activity in MS patients |
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Leurs CE1, van Kempen ZL1, Dekker I2, Balk LJ1, Wattjes MP3, |
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Rispens T4, Uitdehaag BM1, Killestein J1. |
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Author information |
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1 |
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Department of Neurology, Neuroscience Amsterdam, VUmc MS Center |
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Amsterdam, VU University Medical Center, Amsterdam, The |
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Netherlands. |
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2 |
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Department of Neurology, Neuroscience Amsterdam, VUmc MS Center |
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Amsterdam, VU University Medical Center, Amsterdam, The |
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Netherlands / Department of Radiology and Nuclear Medicine, |
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Neuroscience Amsterdam, VUmc MS Center Amsterdam, VU University |
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Medical Center, Amsterdam, The Netherlands. |
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3 |
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Department of Radiology and Nuclear Medicine, Neuroscience |
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Amsterdam, VUmc MS Center Amsterdam, VU University Medical |
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Center, Amsterdam, The Netherlands. |
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4 |
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Department of Immunology, Landsteiner Laboratory Sanquin |
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Research, Amsterdam, The Netherlands. |
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BACKGROUND: |
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Natalizumab is an effective treatment in relapsing-remitting |
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multiple sclerosis (MS). Mainly because of the risk of |
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progressive multifocal leukoencephalopathy (PML), a substantial |
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proportion of John Cunningham (JC) virus-positive patients |
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switch to fingolimod. Previous reports show a clear benefit when |
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the duration of a washout (WO) period of natalizumab is |
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0-3 months in comparison to longer WO periods. However, |
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there is no consensus regarding the optimal duration of a WO |
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period under 3 months. |
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OBJECTIVE: |
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We compared MS disease activity after different WO periods. In |
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addition, we investigated several factors that possibly |
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influence recurrence of disease activity, including serum |
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natalizumab concentration and lymphocyte counts. |
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METHODS: |
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From a prospective observational cohort study of |
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natalizumab-treated patients, we selected 52 patients who |
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switched to fingolimod. We divided the patients in three groups |
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(<6 weeks, 6-8 weeks, >8 weeks WO). Serum |
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natalizumab concentration and lymphocyte count were assessed |
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during and after natalizumab treatment. |
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RESULTS: |
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Patients with a WO period of >8 weeks had a significant |
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higher recurrence of disease activity (odds ratio, 6.8; 95% |
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confidence interval, 1.4-32.8) compared to patients with a WO |
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period of <6 weeks. Serum natalizumab concentration and |
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lymphocyte count did not predict recurrence of disease activity. |
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INTERPRETATION: |
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A short WO period decreases the risk of recurrence of disease |
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activity. The possible impact of a short WO period on the risk |
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of carry-over PML in JC virus-positive patients remains |
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uncertain.[/quote] |
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The abstract can be seen here |
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https://www.ncbi.nlm.nih.gov/pubmed/28823223. |
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