ArticleJournal of neurology2016
Natalizumab discontinuation is associated with a rebound of cognitive impairment in multiple sclerosis patients.
Article in Journal of neurology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Cognitive Efficacy of Pharmacologic Treatments in Multiple Sclerosis: A Systematic Review.CNS drugs · 2020Pooled it
- Computer-assisted rehabilitation of attention in pediatric multiple sclerosis and ADHD patients: a pilot trial.BMC neurology · 2018Trial
- A comparison of natalizumab's effects on SDMT between pediatric-onset and adult-onset multiple sclerosis patients.Frontiers in neurology · 2024Article
- Comparative effectiveness of natalizumab on cognition in multiple sclerosis: A cohort study.Multiple sclerosis (Houndmills, Basingstoke, England) · 2023Article
- The impact of disease modifying therapies on cognitive functions typically impaired in multiple sclerosis patients: a clinician's review.Frontiers in neurology · 2023Review
- A Narrative Review on Axonal Neuroprotection in Multiple Sclerosis.Neurology and therapy · 2022Review
- A Randomized Computer-Assisted Rehabilitation Trial of Attention in Pediatric Multiple Sclerosis: A Post Hoc Analysis.Brain sciences · 2021Article
- Exploring the roles of tryptophan metabolism in MS beyond neuroinflammation and neurodegeneration: A paradigm shift to neuropsychiatric symptoms.Brain, behavior, & immunity - health · 2021Review
- Article
- Cessation of anti-VLA-4 therapy in a focal rat model of multiple sclerosis causes an increase in neuroinflammation.EJNMMI research · 2019Article
- Observational
- Natalizumab reduces serum pro-angiogenic activity in MS patients.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2018Article
- Natalizumab in Multiple Sclerosis: Long-Term Management.International journal of molecular sciences · 2017Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Natalizumab discontinuation is associated with a disease reactivation in multiple sclerosis (MS) patients. Whether this reactivation involves also cognitive functions is not known to date. To assess the persistence of the effect of natalizumab on cognitive functions 1 year after its discontinuation, we compared the longitudinal changes of cognitive performances in two groups of patients. The interrupters, 30 MS patients, have stopped natalizumab due to PML concern, and the continuers, 28 MS patients, continued the treatment. The cognitive impairment index (CII) was used as main outcome measure. As expected, during the natalizumab treatment, we observed a significant reduction of the relapse rate and the number of gadolinium-enhancing lesions along with a reduction of the CII. After 1 year of discontinuation, the beneficial effect on cognitive functions was lost in the interrupters group, as the mean CII increased in comparison with the mean at the end of natalizumab treatment (12.2 ± 7.9 vs 9.3 ± 8.1, p < 0.0001). As opposite, in the continuers group, the CII further decreased after an additional year of treatment (8.4 ± 5.1 vs 9.8 ± 4.6, p = 0.007). A multivariate logistic regression model revealed as predictors of cognitive worsening male sex, disease duration, and the treatment discontinuation. The worsening of cognitive functions after natalizumab discontinuation goes in parallel with the clinical/radiological disease reactivation. Our data reinforce the hypothesis that, in the short-term, natalizumab exerts its positive impact on cognitive functions by means of its anti-inflammatory properties.
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Registered trials
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