Multiple Sclerosis Society of Canada

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Natalizumab drug holiday in multiple sclerosis: Poorly Tolerated

Summary

Natalizumab is a new therapy option for people with multiple sclerosis (MS). It has been suggested that natalizumab-associated progressive multifocal leukoencephalopathy may be prevented by structured interruptions of treatment. Although numbers are small the authors concluded that a natalizumab drug holiday without reinstatement of alternate disease-modifying therapy is poorly tolerated. Killestein J, Vennegoor A, Strijbis EM, Seewann A, van Oosten BW, Uitdehaag BM, Polman CH. Ann Neurol. 2010 Jul 26.

Details
It has been suggested that natalizumab-associated progressive multifocal leukoencephalopathy may be prevented by structured interruptions of treatment. Evidence supporting such a drug holiday is not yet available. Authors present initial observations in 10 multiple sclerosis patients who were stringently monitored up to 6 months after discontinuation of the infusions. Cumulatively, a combination of clinical relapse and new and/or enhanced lesions on magnetic resonance imaging had occurred in 7 of 10 patients. Although numbers are small, they conclude that data suggest that in patients who were switched to natalizumab because of disease activity despite first-line treatment, a natalizumab drug holiday without reinstatement of alternate disease-modifying therapy is poorly tolerated.

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