BACKGROUND: Natalizumab has been recommended for the treatment of relapsing-remitting multiple sclerosis (RRMS) in patients with insufficient response to interferon-beta or glatiramer acetate (disease-modifying treatments-DMT) or in aggressive MS. The pivotal trials were not designed to investigate natalizumab monotherapy in these patient populations. AIM: To investigate the efficacy of natalizumab after treatment failure of previous DMT and in highly active MS. METHODS: A retrospective, multicenter study in Switzerland. Three major MS centers reported all RRMS patients who initiated natalizumab>or=12 months prior to study conduction. RESULTS: 85 RRMS patients were included (72% female, mean age 37.3 years, mean Expanded Disability Status Scale 3.1; 88.2% were pretreated with DMT), and mean treatment duration with natalizumab was 18.4+/-2.6 months. 79% of the patients were relapse-free during the observational period. The annualized relapse rate decreased from 2.0+/-0.6 to 0.27+/-0.2, and 92.9% were progression-free after 12 months (p<0.001). The mean number of gadolinium-enhancing lesions decreased from 1.2+/-1.2 to 0.1+/-0.1 at 12 months' follow-up (91.7% reduction).Discontinuation rate was 11.8% (7.1% for antibody positivity). CONCLUSIONS: Patients who initiate natalizumab after previous high disease activity experience a marked reduction of clinical and MRI disease activity. Copyright (c) 2010 S. Karger AG, Basel.
BACKGROUND:Natalizumab has been recommended for the treatment of relapsing-remitting multiple sclerosis (RRMS) in patients with insufficient response to interferon-beta or glatiramer acetate (disease-modifying treatments-DMT) or in aggressive MS. The pivotal trials were not designed to investigate natalizumab monotherapy in these patient populations. AIM: To investigate the efficacy of natalizumab after treatment failure of previous DMT and in highly active MS. METHODS: A retrospective, multicenter study in Switzerland. Three major MS centers reported all RRMS patients who initiated natalizumab>or=12 months prior to study conduction. RESULTS: 85 RRMS patients were included (72% female, mean age 37.3 years, mean Expanded Disability Status Scale 3.1; 88.2% were pretreated with DMT), and mean treatment duration with natalizumab was 18.4+/-2.6 months. 79% of the patients were relapse-free during the observational period. The annualized relapse rate decreased from 2.0+/-0.6 to 0.27+/-0.2, and 92.9% were progression-free after 12 months (p<0.001). The mean number of gadolinium-enhancing lesions decreased from 1.2+/-1.2 to 0.1+/-0.1 at 12 months' follow-up (91.7% reduction).Discontinuation rate was 11.8% (7.1% for antibody positivity). CONCLUSIONS:Patients who initiate natalizumab after previous high disease activity experience a marked reduction of clinical and MRI disease activity. Copyright (c) 2010 S. Karger AG, Basel.
Authors: Volker Brinkmann; Andreas Billich; Thomas Baumruker; Peter Heining; Robert Schmouder; Gordon Francis; Shreeram Aradhye; Pascale Burtin Journal: Nat Rev Drug Discov Date: 2010-10-29 Impact factor: 84.694
Authors: A Ghezzi; L M E Grimaldi; M G Marrosu; C Pozzilli; G Comi; A Bertolotto; M Trojano; P Gallo; R Capra; D Centonze; E Millefiorini; S Sotgiu; V Brescia Morra; M P Amato; A Lugaresi; G Mancardi; D Caputo; E Montanari; L Provinciali; L Durelli; R Bergamaschi; P Bellantonio; M R Tola; S Cottone; G Savettieri; G Tedeschi Journal: Neurol Sci Date: 2011-04 Impact factor: 3.307
Authors: R Lanzillo; S Bonavita; M Quarantelli; G Vacca; G Lus; L Amato; A Carotenuto; G Tedeschi; G Orefice; V Brescia Morra Journal: Neurol Sci Date: 2012-04-22 Impact factor: 3.307
Authors: Ludwig Kappos; Paul W O'Connor; Christopher H Polman; Patrick Vermersch; Heinz Wiendl; Amy Pace; Annie Zhang; Christophe Hotermans Journal: J Neurol Date: 2013-01-05 Impact factor: 4.849