Use of natalizumab in persons with multiple sclerosis: 2022 update

Morrow, Sarah A.; Clift, Fraser; Devonshire, Virginia; Lapointe, Elvy; Schneider, Raphaël; Stefanelli, Mark; Vosoughi, Reza

doi:10.1016/j.msard.2022.103995

Cited by 33 publications

(18 citation statements)

References 74 publications

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“…Differently, in the present study, patients were treated with natalizumab every 8 weeks during the extension period. Although it could be speculated that larger administration intervals might decrease the drug effectiveness (25), in a previous study involving this patient population, we did not find significant differences between SID administration and the 8-week extension (12).…”

Section: Discussioncontrasting

confidence: 81%

Switch to ocrelizumab in MS patients treated with natalizumab in extended interval dosing at high risk of PML: A 96-week follow-up pilot study

et al. 2023

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We aimed to assess the long-term safety and effectiveness of ocrelizumab in a cohort of patients with multiple sclerosis (MS) at high risk of progressive multifocal leukoencephalopathy (PML), previously treated with natalizumab in extending interval dosing (EID), who switched to ocrelizumab and to compare them with patients who continued EID-natalizumab. Thirty MS patients previously treated with natalizumab in EID (every 8 weeks) were included in this observational retrospective cohort study. Among them, 17 patients were switched to ocrelizumab and 13 continued with EID-natalizumab. Except for the John Cunningham virus (JCV) index, no significant differences were detected between both groups. Main outcome measures included: annualized relapse rate (ARR), radiological activity, disability progression, and the NEDA-3 index. Patients were followed for 96 weeks. The median washout period in ocrelizumab-switchers was 6 weeks. Among them, AAR and radiological activity during follow-up were 0.03, without significant differences in comparison with the previous period on natalizumab-EID. The comparison between ocrelizumab-switchers and patients continuing on EID-natalizumab showed no significant differences in AAR, radiological activity, or disability progression. However, the proportion of patients maintaining a NEDA-3 status in week 96 was slightly superior among ocrelizumab-switchers (94 vs 69%). No serious adverse events were observed in any group. In conclusion, switching from EID-natalizumab to ocrelizumab can be considered as a therapeutic option, particularly in patients with MS at high risk of PML, to mitigate the risks of both PML and disease reactivation.

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Section: Discussioncontrasting

confidence: 81%

Switch to ocrelizumab in MS patients treated with natalizumab in extended interval dosing at high risk of PML: A 96-week follow-up pilot study

et al. 2023

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“…The risk of PML is quite rare in the first year with natalizumab use in RRMS; 5 however, in this case, PML developed early in the first 12 months of treatment when the serum JCV antibody index was less than 1.5, but the previous use of fingolimod may have played a role in increasing this risk. Guidelines offer monitoring every 12 months when the use is less than 24 months use of natalizumab; 6 however, this case demonstrates the potential need to offer MRI the every 3–6 months if serum JCV positive and prior use of fingolimod were both present. Natalizumab 4 weeks interval dosing is associated with higher PML risk than extended interval dosing; 6 in addition, administering the drug at 4-week intervals increases the importance of closer clinical and radiological follow-up for PML risk management in the presence of these both conditions.…”

mentioning

confidence: 89%

“…Guidelines offer monitoring every 12 months when the use is less than 24 months use of natalizumab; 6 however, this case demonstrates the potential need to offer MRI the every 3–6 months if serum JCV positive and prior use of fingolimod were both present. Natalizumab 4 weeks interval dosing is associated with higher PML risk than extended interval dosing; 6 in addition, administering the drug at 4-week intervals increases the importance of closer clinical and radiological follow-up for PML risk management in the presence of these both conditions. In our case, we follow the patient closer with clinically every 6 months interval and we planned MRI after 12 months.…”

mentioning

confidence: 89%

Responsiveness to pembrolizumab in severe early-onset natalizumab associated PML-IRIS in patient with relapsing-remitting multiple sclerosis

Ercan,

Kocer,

Altiparmak

et al. 2024

Mult Scler

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“…The initial therapy for mild forms of RRMS can be successfully conducted with glatiramer acetate and interferons; however, the concomitant presence of skin pathologies or hypercoagulable states impose the use of oral medication. Severe RRMS forms can be treated from the beginning with more potent therapies, Natalizumab being a valuable option as both first and second-line DMT (116). When evolving to SPMS, the patients initially with RRMS become candidates for Siponimod, the latest DMT approved for this type of MS (117).…”

Section: Individualized Asms Treatment and Prognosis In Patients With...mentioning

confidence: 99%

Seizures and multiple sclerosis‑more than an epidemiological association (Review)

Antal

Schreiner

Crihan³

et al. 2022

Exp Ther Med

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In order to increase the quality of life of patients with epilepsy, it is essential to develop tools that facilitate early disease diagnosis and encourage the use of individualized therapies. The association between seizures and other neurological pathologies is well known but incompletely explained, with multiple sclerosis (MS)-seizures correlation being a relevant example. In this context, the present review aimed to highlight the most important facts related to the association between the heterogeneous group of epileptic pathology and MS, in order to provide initial directions for establishing a diagnostic and therapeutic protocol. The first part reviewed the most relevant epidemiological and clinical data on seizures; MS association. Subsequently, it highlighted the most common and actually accepted pathophysiological mechanisms that try to explain the association between the two pathologies. Finally, the importance of paraclinical investigations and the optimal choice of antiseizure-based therapies with respect to seizures associated with MS are presented, also revealing several directions that should be explored in the near future. Contents 1. Introduction 2. Methodology and method 3. Epidemiological data revealing a significant association between MS and seizures 4. Relevant aspects of seizures in patients with MS 5. Pathophysiological mechanisms (incompletely) explaining the MS-epilepsy association 6. The role of imagistic techniques in studying the MS-epilepsy association 7. Neurophysiology in patients with MS with epilepsy-in search of specific patterns 8. Individualized ASMs treatment and prognosis in patients with MS with epilepsy 9. Conclusions

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Use of natalizumab in persons with multiple sclerosis: 2022 update

Cited by 33 publications

References 74 publications

Switch to ocrelizumab in MS patients treated with natalizumab in extended interval dosing at high risk of PML: A 96-week follow-up pilot study

Switch to ocrelizumab in MS patients treated with natalizumab in extended interval dosing at high risk of PML: A 96-week follow-up pilot study

Responsiveness to pembrolizumab in severe early-onset natalizumab associated PML-IRIS in patient with relapsing-remitting multiple sclerosis

Seizures and multiple sclerosis‑more than an epidemiological association (Review)

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