Recurrence or rebound of clinical relapses after discontinuation of natalizumab therapy in highly active MS patients
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  • 作者:Per Soelberg Sorensen (1)
    Nils Koch-Henriksen (2) (3) (6)
    Thor Petersen (4)
    Mads Ravnborg (5)
    Annette Oturai (1)
    Finn Sellebjerg (1)
  • 关键词:Natalizumab treatment discontinuation ; Relapse rebound ; Multiple sclerosis
  • 刊名:Journal of Neurology
  • 出版年:2014
  • 出版时间:June 2014
  • 年:2014
  • 卷:261
  • 期:6
  • 页码:1170-1177
  • 全文大小:
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  • 作者单位:Per Soelberg Sorensen (1)
    Nils Koch-Henriksen (2) (3) (6)
    Thor Petersen (4)
    Mads Ravnborg (5)
    Annette Oturai (1)
    Finn Sellebjerg (1)

    1. Danish Multiple Sclerosis Center, Department of Neurology, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark
    2. Department of Clinical Epidemiology, Clinical Institute, University of Aarhus, ?rhus, Denmark
    3. The Danish Multiple Sclerosis Registry, Neuroscience Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
    6. The Multiple Sclerosis Registry, Rigshospitalet, Copenhagen, Denmark
    4. Department of Neurology, Aarhus University Hospital, ?rhus, Denmark
    5. Department of Neurology, University Hospital of Odense, Odense, Denmark
  • ISSN:1432-1459
文摘
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 3-2?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-.00), 0.47 (95?% CI 0.43-.52) during natalizumab therapy, 0.63 (95?% CI 0.51-.76) 1- months after natalizumab and 0.55 (95?% CI 0.42-.70) 7-2 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.

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