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   DIR Return to: TYSABRI (natalizumab)
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       #Post#: 647--------------------------------------------------
       (Abst.) Tysabri not so effective if you're over 50
       By: agate Date: February 10, 2015, 3:09 pm
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       From Multiple Sclerosis Journal, February 10, 2015:
       [quote]Age-dependent effects on the treatment response of
       natalizumab in MS patients
       Henrik Matell
       Karolinska University Hospital, Sweden
       Jan Lycke
       Sahlgrenska University Hospital, Sweden
       Anders Svenningsson
       Clinical Neuroscience, Umeĺ University, Sweden
       Carolina Holmén
       Karolinska University Hospital, Sweden
       Mohsen Khademi
       Karolinska University Hospital, Sweden
       Jan Hillert
       Karolinska University Hospital, Sweden
       Tomas Olsson
       Karolinska University Hospital, Sweden
       Fredrik Piehl
       Karolinska University Hospital, Sweden
       Karolinska University Hospital, R03:04, S171 76 Stockholm,
       Sweden. henrik.matell@karolinska.se
       Background:
       Natalizumab is approved for treatment of active forms of
       relapsing–remitting multiple sclerosis (MS) based on a pivotal
       phase III study comprising patients aged 18–50 years. The effect
       of natalizumab has not been specifically studied in older
       patients.
       Objective:
       We analyzed age-dependent effects on treatment-related outcome
       measures in 1872 patients, 189 of whom were aged 50 or more,
       included in the Swedish post-marketing natalizumab surveillance
       program.
       Methods:
       In three MS centers registry data for patients aged >50 years
       were validated.
       Results:
       At baseline older patients had longer disease duration, higher
       Expanded Disability Status Scale (EDSS) and lower Symbol Digit
       Modality Test (SDMT) scores than younger patients. The influence
       from natalizumab on outcome measures was significantly reduced
       and 18.7% of patients >50 years stopped treatment for lack of
       effect compared to 7.7% in the younger age group. At baseline,
       the cerebrospinal fluid levels of the chemokine CXCL13 and the
       leukocyte cell count were negatively correlated with age in a
       smaller subgroup of patients.
       Conclusion:
       These results were in agreement with previous findings
       suggesting that inflammation is more pronounced in younger
       patients and therefore the beneficial effects of potent
       anti-inflammatory treatments are subsiding with older
       ages.[/quote]
       The abstract can be seen here
  HTML http://msj.sagepub.com/content/21/1/48?etoc.
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