1 research outputs found
Switching from natalizumab to fingolimod: an observational study
Background – Multiple sclerosis patients who discontinue using
natalizumab are at risk of a rebound in disease activity. However, the
optimal alternative therapy is not currently known. Aims of the
study – We report on clinical and MRI data and patient safety in a
group of relapsing–remitting multiple sclerosis patients who tested
seropositive for the JC virus and who have switched from
natalizumab to fingolimod because of concerns regarding PML risks.
Methods – The test for JC virus antibodies was performed in 18
relapsing–remitting multiple sclerosis patients who were being treated
with natalizumab for more than 1 year. Eight seropositive patients
switched to fingolimod while the seronegative patients continued with
natalizumab. Results – After switching to fingolimod, five of eight
patients (63%) experienced clinical relapses, and MRI activity was
detected in six of eight patients (75%). Neither clinical relapses nor
MRI activity was observed in the patients who continued with
natalizumab. No serious adverse effects were detected. Conclusions –
Natalizumab is an effective treatment for relapsing–remitting multiple
sclerosis, but its discontinuation continues to be a complex problem.
All of the therapies tried thus far, including fingolimod, have been
unable to control the reactivation of the disease. Further studies
addressing alternative therapies after natalizumab discontinuation are
necessary