Switch to ocrelizumab in MS patients treated with natalizumab in extended interval dosing at high risk of PML: A 96-week follow-up pilot study

Article Clinical Neurology

Ocrelizumab versus fingolimod after natalizumab cessation in multiple sclerosis: an observational study

Kevin Bigaut et al.

Summary: This study compared the effectiveness of ocrelizumab and fingolimod after natalizumab cessation. The results showed that ocrelizumab had a significantly lower relapse rate at 1 year compared to fingolimod.

JOURNAL OF NEUROLOGY (2022)

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Article Clinical Neurology

Switch from sequestering to anti-CD20 depleting treatment: disease activity outcomes during wash-out and in the first 6 months of ocrelizumab therapy

Elisabetta Signoriello et al.

Summary: The study found that discontinuation of sequestering agents like fingolimod increases the risk of relapses in multiple sclerosis patients during wash-out period, while starting ocrelizumab before achieving complete immune reconstitution may limit its effectiveness in the first 6 months.

MULTIPLE SCLEROSIS JOURNAL (2022)

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Article Clinical Neurology

PML risk is the main factor driving the choice of discontinuing natalizumab in a large multiple sclerosis population: results from an Italian multicenter retrospective study

Clara G. Chisari et al.

Summary: Approximately 60% of MS patients in Italy continued NTZ treatment during the observation period. Those who required discontinuation did so mainly due to concerns about PML.

JOURNAL OF NEUROLOGY (2022)

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Article Clinical Neurology

Comparison of switching to 6-week dosing of natalizumab versus continuing with 4-week dosing in patients with relapsing-remitting multiple sclerosis (NOVA): a randomised, controlled, open-label, phase 3b trial

John F. Foley et al.

Summary: This study aimed to assess the safety and efficacy of natalizumab dosing once every 6 weeks compared to once every 4 weeks in patients with relapsing-remitting multiple sclerosis. The results showed a numerical difference in the number of new or newly enlarging T2 hyperintense lesions at week 72 between the two dosing regimens, which reached statistical significance under the secondary estimand. The safety profiles of natalizumab dosing once every 6 weeks and once every 4 weeks were similar.

LANCET NEUROLOGY (2022)

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Review Clinical Neurology

Use of natalizumab in persons with multiple sclerosis: 2022 update

Sarah A. Morrow et al.

Summary: A group of neurologists from Canada convened in September 2021 to update the 2015 Canadian practice recommendations for the use of natalizumab in patients with multiple sclerosis (MS). The updated recommendations focus on long-term efficacy and safety data, patient selection based on JCV index criteria, risk management strategies for progressive leukoencephalopathy (PML), and options for switching to alternative disease-modifying therapies.

MULTIPLE SCLEROSIS AND RELATED DISORDERS (2022)

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Review Medicine, General & Internal

Ocrelizumab for multiple sclerosis

Mengbing Lin et al.

Summary: Ocrelizumab is an effective treatment for RRMS, reducing relapse rate and disability progression. It is well tolerated with no significant difference in adverse events compared to interferon beta-la. However, for PPMS, ocrelizumab may lead to a higher rate of adverse events compared to placebo, but it can reduce disability progression and has no significant difference in serious adverse events. Ocrelizumab shows promising results in MS treatment but further research is needed.

COCHRANE DATABASE OF SYSTEMATIC REVIEWS (2022)

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Article Clinical Neurology

Switching to ocrelizumab in RRMS patients at risk of PML previously treated with extended interval dosing of natalizumab

Chiara Rosa Mancinelli et al.

Summary: Discontinuation of natalizumab in RRMS patients at risk of PML can lead to disease reactivation, but switching to ocrelizumab may help mitigate this risk. MRI and clinical monitoring showed disease reactivation in a small percentage of patients during the first 3 months, but subsequent treatment with ocrelizumab resulted in stable EDSS scores and no further relapses after 6 months.

MULTIPLE SCLEROSIS JOURNAL (2021)

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Article Clinical Neurology

Exit Strategies in Natalizumab-Treated RRMS at High Risk of Progressive Multifocal Leukoencephalopathy: a Multicentre Comparison Study

Aurora Zanghi et al.

Summary: This study evaluated the efficacy and safety of OCR, RTX, and CLA as NTZ exit strategies in RRMS patients, finding that patients on OCR had lower ARR and less MRI activity. The three groups showed similar rates of adverse events. Anti-CD20 drugs were deemed effective and safe options for NTZ exit strategies, with all investigated DMTs demonstrating a good safety profile.

NEUROTHERAPEUTICS (2021)

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Article Immunology

Does Extended Interval Dosing Natalizumab Preserve Effectiveness in Multiple Sclerosis? A 7 Year-Retrospective Observational Study

Javier Riancho et al.

Summary: Observational study on the long-term effectiveness of natalizumab with extended interval dosing (EID) in multiple sclerosis patients treated for over 7 years showed that EID preserved treatment efficacy and prevented disability worsening during follow-up. Patients treated with natalizumab for the first time showed slightly better response to EID therapy compared to those previously treated with other immunosuppressive drugs.

FRONTIERS IN IMMUNOLOGY (2021)

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Article Clinical Neurology

Ocrelizumab after natalizumab in JC-virus positive relapsing remitting multiple sclerosis patients

Z. Y. G. J. van Lierop et al.

Summary: The study showed that for JC-virus positive multiple sclerosis patients, switching from natalizumab to ocrelizumab, direct switchers had better outcomes, although there was a risk of carry-over PML.

MULTIPLE SCLEROSIS JOURNAL-EXPERIMENTAL TRANSLATIONAL AND CLINICAL (2021)

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Article Clinical Neurology