Experiences in treatment of multiple sclerosis with natalizumab from a real-life cohort over 15 years.
Adult
Disease Progression
Drug Substitution
Female
Humans
Male
Multiple Sclerosis
/ drug therapy
Multiple Sclerosis, Chronic Progressive
/ etiology
Multiple Sclerosis, Relapsing-Remitting
/ etiology
Natalizumab
/ therapeutic use
Recurrence
Retrospective Studies
Risk Factors
Time Factors
Withholding Treatment
Journal
Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288
Informations de publication
Date de publication:
02 12 2021
02 12 2021
Historique:
received:
21
09
2021
accepted:
16
11
2021
entrez:
3
12
2021
pubmed:
4
12
2021
medline:
1
2
2022
Statut:
epublish
Résumé
Natalizumab (NTZ) has been used for treatment of highly active relapsing-remitting multiple sclerosis (MS). When stopping NTZ the risk of severe rebound phenomenon has to be considered. We aimed to investigate the use of NTZ in clinical routine and focused on identification of potential risk factors for disease reactivation after treatment discontinuation. At the Medical University of Innsbruck, Austria, we identified all MS patients who were treated with NTZ and performed a retrospective analysis on therapeutic decision making, disease course before, during and after treatment with NTZ and on risk factors for disease reactivation after NTZ discontinuation. 235 NTZ treated MS patients were included, of whom 105 had discontinued treatment. At NTZ start disease duration was 5.09 (IQR 2.09-10.57) years, average number of total relapses was 4 (IQR 3-6) and median EDSS 2.0 (range 0-6.5), whereby these values significantly decreased over time. Reduction of annualized relapse rate (ARR) on treatment was 93% and EDSS remained stable in 64%. In multivariate regression models only conversion to secondary progressive MS (SPMS) on treatment was significantly associated with lower risk of disease reactivation after NTZ, while ARR before treatment was associated with earlier disease reactivation. We could confirm the high therapeutic efficacy of NTZ which trends to be used earlier in the disease course nowadays. Discontinuation of NTZ seems safe only in patients who convert to SPMS during treatment, while higher ARR before NTZ increases the risk of disease reactivation after treatment discontinuation.
Identifiants
pubmed: 34857795
doi: 10.1038/s41598-021-02665-6
pii: 10.1038/s41598-021-02665-6
pmc: PMC8639988
doi:
Substances chimiques
Natalizumab
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
23317Informations de copyright
© 2021. The Author(s).
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