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