Observational studyMultiple sclerosis (Houndmills, Basingstoke, England)2018
Switching natalizumab to fingolimod within 6 weeks reduces recurrence of disease activity in MS patients.
Observational study in Multiple sclerosis (Houndmills, Basingstoke, England), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- Building Towards Initiation, Moderation, De-Escalation and Cessation of Disease-Modifying Treatments for Multiple Sclerosis in Greece: An Expert Panel Consensus Meeting.Brain sciences · 2026Article
- De-Escalation Treatment Strategies From Natalizumab in Patients With Relapsing Multiple Sclerosis in Austria.European journal of neurology · 2025Article
- De-escalation and Discontinuation of Disease-Modifying Therapies in Multiple Sclerosis.Current neurology and neuroscience reports · 2024Review
- Risk of multiple sclerosis relapses when switching from fingolimod to cell-depleting agents: the role of washout duration.Journal of neurology · 2022Article
- Safety of Fingolimod in Patients with Multiple Sclerosis Switched from Natalizumab: Results from TRANSITION-A 2-Year, Multicenter, Observational, Cohort Study.Brain sciences · 2022Article
- The results of a 24-month controlled, prospective study of relapsing multiple sclerosis patients at risk for progressive multifocal encephalopathy, who switched from prolonged use of natalizumab to teriflunomide.Multiple sclerosis journal - experimental, translational and clinical · 2021Article
- Real-World Effectiveness of Natalizumab in Korean Patients With Multiple Sclerosis.Frontiers in neurology · 2021Article
- Disease activity outcomes with different washout periods after switching from natalizumab to an alternative disease-modifying therapy.Journal of neurology · 2020Article
- Switching from natalizumab to fingolimod treatment in multiple sclerosis: real life data from the Austrian MS Treatment Registry.Journal of neurology · 2019Observational
- Managing Risks with Immune Therapies in Multiple Sclerosis.Drug safety · 2019Review
- Efficacy and safety of alemtuzumab versus fingolimod in RRMS after natalizumab cessation.Journal of neurology · 2019Article
- Reducing return of disease activity in patients with relapsing multiple sclerosis transitioned from natalizumab to teriflunomide: 12-month interim results of teriflunomide therapy.Multiple sclerosis journal - experimental, translational and clinicalArticle
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNatalizumab is an effective treatment in relapsing-remitting multiple sclerosis (MS). Mainly because of the risk of progressive multifocal leukoencephalopathy (PML), a substantial proportion of John Cunningham (JC) virus-positive patients switch to fingolimod. Previous reports show a clear benefit when the duration of a washout (WO) period of natalizumab is 0-3 months in comparison to longer WO periods. However, there is no consensus regarding the optimal duration of a WO period under 3 months.
objectiveWe compared MS disease activity after different WO periods. In addition, we investigated several factors that possibly influence recurrence of disease activity, including serum natalizumab concentration and lymphocyte counts.
methodsFrom a prospective observational cohort study of natalizumab-treated patients, we selected 52 patients who switched to fingolimod. We divided the patients in three groups (<6 weeks, 6-8 weeks, >8 weeks WO). Serum natalizumab concentration and lymphocyte count were assessed during and after natalizumab treatment.
resultsPatients with a WO period of >8 weeks had a significant higher recurrence of disease activity (odds ratio, 6.8; 95% confidence interval, 1.4-32.8) compared to patients with a WO period of <6 weeks. Serum natalizumab concentration and lymphocyte count did not predict recurrence of disease activity.
interpretationA short WO period decreases the risk of recurrence of disease activity. The possible impact of a short WO period on the risk of carry-over PML in JC virus-positive patients remains uncertain.
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