Brandi Vollmer1, Justin M Honce2, Stefan Sillau1, John R Corboy1, Timothy Vollmer1, Kavita Nair3, Enrique Alvarez4. 1. Department of Neurology, Division of Neuroimmunology, Rocky Mountain Multiple Sclerosis Center at the University of Colorado Denver, Academic Office 1 Building, Room 5512, 12631 East 17th Avenue, Mail Stop B185, Aurora, CO 80045, USA. 2. Department of Radiology, Division of Neuroradiology, University of Colorado Denver, 12605 E. 16th Ave, Aurora, CO 80045, USA. 3. Department of Neurology, Division of Neuroimmunology, Rocky Mountain Multiple Sclerosis Center at the University of Colorado Denver, Academic Office 1 Building, Room 5512, 12631 East 17th Avenue, Mail Stop B185, Aurora, CO 80045, USA; Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, 12850 East Montview Blvd, C-238, Aurora, CO 80045, USA. 4. Department of Neurology, Division of Neuroimmunology, Rocky Mountain Multiple Sclerosis Center at the University of Colorado Denver, Academic Office 1 Building, Room 5512, 12631 East 17th Avenue, Mail Stop B185, Aurora, CO 80045, USA. Electronic address: Enrique.alvarez@ucdenver.edu.
Abstract
BACKGROUND: Due to the recurrence of disease activity in multiple sclerosis (MS) patients, a washout period of <3 months has been suggested for the transition from natalizumab (NTZ) to fingolimod (FTY). However, very short transition periods of <1 month may be more beneficial. METHODS: Retrospective analysis of patients from the Rocky Mountain MS Center at the University of Colorado who were: a) on NTZ for ≥6 months prior to switching to FTY; b) had a transition period ≤ 6 months; and c) initiated FTY treatment prior to November 2013. Transition periods were grouped as follows: <1 month, 1-2 months, and 3-6 months. Outcomes assessed include clinical and MRI measures within one year of FTY initiation. RESULTS: Thirty-seven, 56 and 24 patients had a transition period < 1 month, 1-2 months and 3-6 months, respectively. Baseline characteristics were well matched: mean age 45-49 years (p = 0.17), disease duration 11-13 years (p = 0.42), and ~70% women (p = 1.00). Following the switch (including transition period), clinical relapses were observed in 0% (<1 month), 12.5% (1-2 months), 37.5% (3-6 month) (p < 0.001) of patients. New gadolinium enhancing lesions occurred in 3.3% (<1 month), 13% (1-2 months), 21.4% (3-6 months) (p = 0.13) patients. New T2 lesions were observed in 11.1% (<1 month), 16.3% (1-2 months), 33.3% (3-6 months) (p = 0.28) of patients. There were no unexpected adverse events or PML observed. CONCLUSIONS: Minimizing transition times from NTZ to FTY was beneficial and safe.
BACKGROUND: Due to the recurrence of disease activity in multiple sclerosis (MS) patients, a washout period of <3 months has been suggested for the transition from natalizumab (NTZ) to fingolimod (FTY). However, very short transition periods of <1 month may be more beneficial. METHODS: Retrospective analysis of patients from the Rocky Mountain MS Center at the University of Colorado who were: a) on NTZ for ≥6 months prior to switching to FTY; b) had a transition period ≤ 6 months; and c) initiated FTY treatment prior to November 2013. Transition periods were grouped as follows: <1 month, 1-2 months, and 3-6 months. Outcomes assessed include clinical and MRI measures within one year of FTY initiation. RESULTS: Thirty-seven, 56 and 24 patients had a transition period < 1 month, 1-2 months and 3-6 months, respectively. Baseline characteristics were well matched: mean age 45-49 years (p = 0.17), disease duration 11-13 years (p = 0.42), and ~70% women (p = 1.00). Following the switch (including transition period), clinical relapses were observed in 0% (<1 month), 12.5% (1-2 months), 37.5% (3-6 month) (p < 0.001) of patients. New gadolinium enhancing lesions occurred in 3.3% (<1 month), 13% (1-2 months), 21.4% (3-6 months) (p = 0.13) patients. New T2 lesions were observed in 11.1% (<1 month), 16.3% (1-2 months), 33.3% (3-6 months) (p = 0.28) of patients. There were no unexpected adverse events or PML observed. CONCLUSIONS: Minimizing transition times from NTZ to FTY was beneficial and safe.
Authors: Michael Guger; Christian Enzinger; Fritz Leutmezer; Jörg Kraus; Stefan Kalcher; Erich Kvas; Thomas Berger Journal: J Neurol Date: 2019-07-16 Impact factor: 4.849
Authors: Helmut Butzkueven; Paul S Giacomini; Stanley Cohan; Tjalf Ziemssen; Daniel Sienkiewicz; Ying Zhang; Yvonne Geissbühler; Diego Silva; Davorka Tomic; Harald Kropshofer; Maria Trojano Journal: Brain Sci Date: 2022-02-04