Recurrence or rebound of clinical relapses after discontinuation of natalizumab therapy in highly active MS patients
Publikation: Bidrag til tidsskrift › Letter › Forskning › fagfællebedømt
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Recurrence or rebound of clinical relapses after discontinuation of natalizumab therapy in highly active MS patients. / Sorensen, Per Soelberg; Koch-Henriksen, Nils; Petersen, Thor; Ravnborg, Mads; Oturai, Annette; Sellebjerg, Finn.
I: Journal of Neurology, Bind 261, Nr. 6, 06.2014, s. 1170-1177.Publikation: Bidrag til tidsskrift › Letter › Forskning › fagfællebedømt
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T1 - Recurrence or rebound of clinical relapses after discontinuation of natalizumab therapy in highly active MS patients
AU - Sorensen, Per Soelberg
AU - Koch-Henriksen, Nils
AU - Petersen, Thor
AU - Ravnborg, Mads
AU - Oturai, Annette
AU - Sellebjerg, Finn
PY - 2014/6
Y1 - 2014/6
N2 - A number of studies have reported flare-up of multiple sclerosis (MS) disease activity after cessation of natalizumab, increasing to a level beyond the pre-natalizumab treatment level. Our aim was to describe the development in clinical disease activity following cessation of natalizumab therapy in a large unselected cohort of highly active patients. We studied 375 highly active patients who had suffered at least two significant relapses within 1 year or three relapses within 2 years, or had been treated with mitoxantrone for highly active disease. All patients had discontinued therapy with natalizumab after at least 24 weeks on therapy, and had been followed 3-12 months (mean 8.9 months) after cessation of natalizumab therapy. The annualised relapse rate before start of natalizumab therapy was 0.94 (95 % confidence interval [CI] 0.88-1.00), 0.47 (95 % CI 0.43-0.52) during natalizumab therapy, 0.63 (95 % CI 0.51-0.76) 1-6 months after natalizumab and 0.55 (95 % CI 0.42-0.70) 7-12 months after natalizumab. However, 83 (22 %) of the patients could be classified as showing rebound of relapses, defined as a higher individual relapse rate after cessation of natalizumab than before natalizumab. These patients had a higher annualised relapse rate during natalizumab therapy. For the whole patient group, the relapse rate after discontinuation did not exceed the pre-natalizumab relapse rate at any time, but 22 % of the patients showed rebound of relapses after discontinuation of natalizumab.
AB - A number of studies have reported flare-up of multiple sclerosis (MS) disease activity after cessation of natalizumab, increasing to a level beyond the pre-natalizumab treatment level. Our aim was to describe the development in clinical disease activity following cessation of natalizumab therapy in a large unselected cohort of highly active patients. We studied 375 highly active patients who had suffered at least two significant relapses within 1 year or three relapses within 2 years, or had been treated with mitoxantrone for highly active disease. All patients had discontinued therapy with natalizumab after at least 24 weeks on therapy, and had been followed 3-12 months (mean 8.9 months) after cessation of natalizumab therapy. The annualised relapse rate before start of natalizumab therapy was 0.94 (95 % confidence interval [CI] 0.88-1.00), 0.47 (95 % CI 0.43-0.52) during natalizumab therapy, 0.63 (95 % CI 0.51-0.76) 1-6 months after natalizumab and 0.55 (95 % CI 0.42-0.70) 7-12 months after natalizumab. However, 83 (22 %) of the patients could be classified as showing rebound of relapses, defined as a higher individual relapse rate after cessation of natalizumab than before natalizumab. These patients had a higher annualised relapse rate during natalizumab therapy. For the whole patient group, the relapse rate after discontinuation did not exceed the pre-natalizumab relapse rate at any time, but 22 % of the patients showed rebound of relapses after discontinuation of natalizumab.
KW - Adolescent
KW - Adult
KW - Antibodies, Monoclonal, Humanized
KW - Denmark
KW - Female
KW - Humans
KW - Immunologic Factors
KW - Longitudinal Studies
KW - Male
KW - Middle Aged
KW - Multiple Sclerosis
KW - Recurrence
KW - Retrospective Studies
KW - Time Factors
KW - Treatment Outcome
KW - Young Adult
U2 - 10.1007/s00415-014-7325-8
DO - 10.1007/s00415-014-7325-8
M3 - Letter
C2 - 24728334
VL - 261
SP - 1170
EP - 1177
JO - Deutsche Zeitschrift fur Nervenheilkunde
JF - Deutsche Zeitschrift fur Nervenheilkunde
SN - 0939-1517
IS - 6
ER -
ID: 138508541