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Shortening the washout to 4 weeks when switching from natalizumab to fingolimod and risk of disease reactivation in multiple sclerosis.
- Source :
-
Multiple sclerosis and related disorders [Mult Scler Relat Disord] 2018 Oct; Vol. 25, pp. 14-20. Date of Electronic Publication: 2018 Jul 06. - Publication Year :
- 2018
-
Abstract
- Background: There is limited evidence about the optimal length of washout when switching from natalizumab to fingolimod.<br />Objective: To study if a washout period of 4 weeks is associated with less disease activity compared to 8 weeks.<br />Methods: 25 patients with Relapsing Remitting Multiple Sclerosis were included in an open label, prospective study with a follow-up of 108 weeks. The primary endpoint (PE) was defined as "time to first relapse or MRI disease activity up to week 56". In addition, a recurrent event analysis (REA) was performed up to week 108.<br />Results: The PE was not met (HR 0.67, 95% CI [0.22,1.97], p = 0.462). Number of relapses before stopping natalizumab was positively associated with the hazard of relapse (HR 3.91, p = 0.0117, 95% CI [1.36, 11.28]). The REA showed a reduction of the hazard to develop a relapse by 77% (HR 0.23, 95% CI [0.08, 0.69], p = 0.00854) in favor of the cohort with 4 weeks washout.<br />Conclusions: Our study suggests that switching from natalizumab to fingolimod with a shorter washout of 4 weeks might reduce the risk of disease reactivation after switching.<br /> (Copyright © 2018 The Author(s). Published by Elsevier B.V. All rights reserved.)
- Subjects :
- Adult
Brain diagnostic imaging
Brain drug effects
Disability Evaluation
Female
Follow-Up Studies
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Multiple Sclerosis diagnostic imaging
Prohibitins
Statistics, Nonparametric
Time Factors
Young Adult
Drug Substitution methods
Fingolimod Hydrochloride therapeutic use
Immunologic Factors therapeutic use
Multiple Sclerosis drug therapy
Natalizumab therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 2211-0356
- Volume :
- 25
- Database :
- MEDLINE
- Journal :
- Multiple sclerosis and related disorders
- Publication Type :
- Academic Journal
- Accession number :
- 30014876
- Full Text :
- https://doi.org/10.1016/j.msard.2018.07.005