Natalizumab in Multiple Sclerosis: Long-Term Management
Natalizumab is a monoclonal antibody highly effective in the treatment of relapsing remitting multiple sclerosis (RRMS) patients. Despite its effectiveness, there are growing concerns regarding the risk of progressive multifocal leukoencephalopathy (PML), a brain infection caused by John Cunningham...
Gespeichert in:
| Veröffentlicht in: | International journal of molecular sciences 2017-04, Vol.18 (5), p.940 |
|---|---|
| Hauptverfasser: | , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | |
|---|---|
| container_issue | 5 |
| container_start_page | 940 |
| container_title | International journal of molecular sciences |
| container_volume | 18 |
| creator | Clerico, Marinella Artusi, Carlo Alberto Liberto, Alessandra Di Rolla, Simona Bardina, Valentina Barbero, Pierangelo Mercanti, Stefania Federica De Durelli, Luca |
| description | Natalizumab is a monoclonal antibody highly effective in the treatment of relapsing remitting multiple sclerosis (RRMS) patients. Despite its effectiveness, there are growing concerns regarding the risk of progressive multifocal leukoencephalopathy (PML), a brain infection caused by John Cunningham virus (JCV), particularly after 24 doses and in patients who previously received immunosuppressive drugs. Long-term natalizumab treated, immunosuppressive-pretreated, and JCV antibody-positive patients are asked to rediscuss natalizumab continuation or withdrawal after 24 doses. Until now, there has not been a clear strategy that should be followed to avoid PML risk and in parallel reduce clinical and radiological rebound activity. In this review, we analyzed the results of clinical trials and case reports in relation to the following situations: natalizumab continuation, natalizumab discontinuation followed by full therapeutic suspension or switch to other first or second line MS treatments. Quitting all MS treatment after natalizumab increases MS activity occurrence. The results regarding the therapeutic switch are not homogeneous, so at the moment there are no established guidelines regarding natalizumab treatment after 24 administrations; the choice is currently based on the professional experience of the neurologist, and on patients' clinical features and preferences. |
| doi_str_mv | 10.3390/ijms18050940 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5454853</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1910599182</sourcerecordid><originalsourceid>FETCH-LOGICAL-c412t-a320930cfaf4d54a55d44ed6ca603c15a63d177a4d27ff0efaaae22e02cc7d043</originalsourceid><addsrcrecordid>eNpdkctLw0AQxhdRfFRvniXgxYPR2VeS9SBI8QWtHqznZbrZ1C2bpGYTQf96I62lepqB-fHNfPMRckzhgnMFl25eBpqBBCVgi-xTwVgMkKTbG_0eOQhhDsA4k2qX7LFMJBmTYp-kT9iid19didPIVdG4861beBu9GG-bOrhwFY3qahZPbFNGY6xwZktbtYdkp0Af7NGqDsjr3e1k-BCPnu8fhzej2AjK2hg5A8XBFFiIXAqUMhfC5onBBLihEhOe0zRFkbO0KMAWiGgZs8CMSXMQfECul7qLblra3PSrG_R60bgSm09do9N_J5V707P6Q0shRSZ5L3C2Emjq986GVpcuGOs9VrbugqaZkixNk54dkNN_6Lzumqq3p6miIJWiGeup8yVl-veExhbrYyjon0T0ZiI9frJpYA3_RsC_ARXih04</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1910599182</pqid></control><display><type>article</type><title>Natalizumab in Multiple Sclerosis: Long-Term Management</title><source>MEDLINE</source><source>MDPI - Multidisciplinary Digital Publishing Institute</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><creator>Clerico, Marinella ; Artusi, Carlo Alberto ; Liberto, Alessandra Di ; Rolla, Simona ; Bardina, Valentina ; Barbero, Pierangelo ; Mercanti, Stefania Federica De ; Durelli, Luca</creator><creatorcontrib>Clerico, Marinella ; Artusi, Carlo Alberto ; Liberto, Alessandra Di ; Rolla, Simona ; Bardina, Valentina ; Barbero, Pierangelo ; Mercanti, Stefania Federica De ; Durelli, Luca</creatorcontrib><description>Natalizumab is a monoclonal antibody highly effective in the treatment of relapsing remitting multiple sclerosis (RRMS) patients. Despite its effectiveness, there are growing concerns regarding the risk of progressive multifocal leukoencephalopathy (PML), a brain infection caused by John Cunningham virus (JCV), particularly after 24 doses and in patients who previously received immunosuppressive drugs. Long-term natalizumab treated, immunosuppressive-pretreated, and JCV antibody-positive patients are asked to rediscuss natalizumab continuation or withdrawal after 24 doses. Until now, there has not been a clear strategy that should be followed to avoid PML risk and in parallel reduce clinical and radiological rebound activity. In this review, we analyzed the results of clinical trials and case reports in relation to the following situations: natalizumab continuation, natalizumab discontinuation followed by full therapeutic suspension or switch to other first or second line MS treatments. Quitting all MS treatment after natalizumab increases MS activity occurrence. The results regarding the therapeutic switch are not homogeneous, so at the moment there are no established guidelines regarding natalizumab treatment after 24 administrations; the choice is currently based on the professional experience of the neurologist, and on patients' clinical features and preferences.</description><identifier>ISSN: 1422-0067</identifier><identifier>ISSN: 1661-6596</identifier><identifier>EISSN: 1422-0067</identifier><identifier>DOI: 10.3390/ijms18050940</identifier><identifier>PMID: 28468254</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Adrenal Cortex Hormones - therapeutic use ; Animals ; Antibodies, Monoclonal - administration & dosage ; Antibodies, Monoclonal - adverse effects ; Antibodies, Monoclonal - therapeutic use ; Case reports ; Clinical trials ; Drugs ; Encephalitis ; Humans ; Immunologic Factors - administration & dosage ; Immunologic Factors - adverse effects ; Immunologic Factors - therapeutic use ; Immunosuppressive agents ; Immunotherapy ; JC Virus - isolation & purification ; Leukoencephalopathy ; Leukoencephalopathy, Progressive Multifocal - diagnosis ; Leukoencephalopathy, Progressive Multifocal - etiology ; Medical research ; Monoclonal antibodies ; Multiple sclerosis ; Multiple Sclerosis - drug therapy ; Natalizumab - administration & dosage ; Natalizumab - adverse effects ; Natalizumab - therapeutic use ; Patients ; Progressive multifocal leukoencephalopathy ; Review ; Risk ; Viral infections</subject><ispartof>International journal of molecular sciences, 2017-04, Vol.18 (5), p.940</ispartof><rights>Copyright MDPI AG 2017</rights><rights>2017 by the authors. 2017</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c412t-a320930cfaf4d54a55d44ed6ca603c15a63d177a4d27ff0efaaae22e02cc7d043</citedby><cites>FETCH-LOGICAL-c412t-a320930cfaf4d54a55d44ed6ca603c15a63d177a4d27ff0efaaae22e02cc7d043</cites><orcidid>0000-0002-6371-7354</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5454853/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5454853/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28468254$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Clerico, Marinella</creatorcontrib><creatorcontrib>Artusi, Carlo Alberto</creatorcontrib><creatorcontrib>Liberto, Alessandra Di</creatorcontrib><creatorcontrib>Rolla, Simona</creatorcontrib><creatorcontrib>Bardina, Valentina</creatorcontrib><creatorcontrib>Barbero, Pierangelo</creatorcontrib><creatorcontrib>Mercanti, Stefania Federica De</creatorcontrib><creatorcontrib>Durelli, Luca</creatorcontrib><title>Natalizumab in Multiple Sclerosis: Long-Term Management</title><title>International journal of molecular sciences</title><addtitle>Int J Mol Sci</addtitle><description>Natalizumab is a monoclonal antibody highly effective in the treatment of relapsing remitting multiple sclerosis (RRMS) patients. Despite its effectiveness, there are growing concerns regarding the risk of progressive multifocal leukoencephalopathy (PML), a brain infection caused by John Cunningham virus (JCV), particularly after 24 doses and in patients who previously received immunosuppressive drugs. Long-term natalizumab treated, immunosuppressive-pretreated, and JCV antibody-positive patients are asked to rediscuss natalizumab continuation or withdrawal after 24 doses. Until now, there has not been a clear strategy that should be followed to avoid PML risk and in parallel reduce clinical and radiological rebound activity. In this review, we analyzed the results of clinical trials and case reports in relation to the following situations: natalizumab continuation, natalizumab discontinuation followed by full therapeutic suspension or switch to other first or second line MS treatments. Quitting all MS treatment after natalizumab increases MS activity occurrence. The results regarding the therapeutic switch are not homogeneous, so at the moment there are no established guidelines regarding natalizumab treatment after 24 administrations; the choice is currently based on the professional experience of the neurologist, and on patients' clinical features and preferences.</description><subject>Adrenal Cortex Hormones - therapeutic use</subject><subject>Animals</subject><subject>Antibodies, Monoclonal - administration & dosage</subject><subject>Antibodies, Monoclonal - adverse effects</subject><subject>Antibodies, Monoclonal - therapeutic use</subject><subject>Case reports</subject><subject>Clinical trials</subject><subject>Drugs</subject><subject>Encephalitis</subject><subject>Humans</subject><subject>Immunologic Factors - administration & dosage</subject><subject>Immunologic Factors - adverse effects</subject><subject>Immunologic Factors - therapeutic use</subject><subject>Immunosuppressive agents</subject><subject>Immunotherapy</subject><subject>JC Virus - isolation & purification</subject><subject>Leukoencephalopathy</subject><subject>Leukoencephalopathy, Progressive Multifocal - diagnosis</subject><subject>Leukoencephalopathy, Progressive Multifocal - etiology</subject><subject>Medical research</subject><subject>Monoclonal antibodies</subject><subject>Multiple sclerosis</subject><subject>Multiple Sclerosis - drug therapy</subject><subject>Natalizumab - administration & dosage</subject><subject>Natalizumab - adverse effects</subject><subject>Natalizumab - therapeutic use</subject><subject>Patients</subject><subject>Progressive multifocal leukoencephalopathy</subject><subject>Review</subject><subject>Risk</subject><subject>Viral infections</subject><issn>1422-0067</issn><issn>1661-6596</issn><issn>1422-0067</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNpdkctLw0AQxhdRfFRvniXgxYPR2VeS9SBI8QWtHqznZbrZ1C2bpGYTQf96I62lepqB-fHNfPMRckzhgnMFl25eBpqBBCVgi-xTwVgMkKTbG_0eOQhhDsA4k2qX7LFMJBmTYp-kT9iid19didPIVdG4861beBu9GG-bOrhwFY3qahZPbFNGY6xwZktbtYdkp0Af7NGqDsjr3e1k-BCPnu8fhzej2AjK2hg5A8XBFFiIXAqUMhfC5onBBLihEhOe0zRFkbO0KMAWiGgZs8CMSXMQfECul7qLblra3PSrG_R60bgSm09do9N_J5V707P6Q0shRSZ5L3C2Emjq986GVpcuGOs9VrbugqaZkixNk54dkNN_6Lzumqq3p6miIJWiGeup8yVl-veExhbrYyjon0T0ZiI9frJpYA3_RsC_ARXih04</recordid><startdate>20170429</startdate><enddate>20170429</enddate><creator>Clerico, Marinella</creator><creator>Artusi, Carlo Alberto</creator><creator>Liberto, Alessandra Di</creator><creator>Rolla, Simona</creator><creator>Bardina, Valentina</creator><creator>Barbero, Pierangelo</creator><creator>Mercanti, Stefania Federica De</creator><creator>Durelli, Luca</creator><general>MDPI AG</general><general>MDPI</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-6371-7354</orcidid></search><sort><creationdate>20170429</creationdate><title>Natalizumab in Multiple Sclerosis: Long-Term Management</title><author>Clerico, Marinella ; Artusi, Carlo Alberto ; Liberto, Alessandra Di ; Rolla, Simona ; Bardina, Valentina ; Barbero, Pierangelo ; Mercanti, Stefania Federica De ; Durelli, Luca</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c412t-a320930cfaf4d54a55d44ed6ca603c15a63d177a4d27ff0efaaae22e02cc7d043</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adrenal Cortex Hormones - therapeutic use</topic><topic>Animals</topic><topic>Antibodies, Monoclonal - administration & dosage</topic><topic>Antibodies, Monoclonal - adverse effects</topic><topic>Antibodies, Monoclonal - therapeutic use</topic><topic>Case reports</topic><topic>Clinical trials</topic><topic>Drugs</topic><topic>Encephalitis</topic><topic>Humans</topic><topic>Immunologic Factors - administration & dosage</topic><topic>Immunologic Factors - adverse effects</topic><topic>Immunologic Factors - therapeutic use</topic><topic>Immunosuppressive agents</topic><topic>Immunotherapy</topic><topic>JC Virus - isolation & purification</topic><topic>Leukoencephalopathy</topic><topic>Leukoencephalopathy, Progressive Multifocal - diagnosis</topic><topic>Leukoencephalopathy, Progressive Multifocal - etiology</topic><topic>Medical research</topic><topic>Monoclonal antibodies</topic><topic>Multiple sclerosis</topic><topic>Multiple Sclerosis - drug therapy</topic><topic>Natalizumab - administration & dosage</topic><topic>Natalizumab - adverse effects</topic><topic>Natalizumab - therapeutic use</topic><topic>Patients</topic><topic>Progressive multifocal leukoencephalopathy</topic><topic>Review</topic><topic>Risk</topic><topic>Viral infections</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Clerico, Marinella</creatorcontrib><creatorcontrib>Artusi, Carlo Alberto</creatorcontrib><creatorcontrib>Liberto, Alessandra Di</creatorcontrib><creatorcontrib>Rolla, Simona</creatorcontrib><creatorcontrib>Bardina, Valentina</creatorcontrib><creatorcontrib>Barbero, Pierangelo</creatorcontrib><creatorcontrib>Mercanti, Stefania Federica De</creatorcontrib><creatorcontrib>Durelli, Luca</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Access via ProQuest (Open Access)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>International journal of molecular sciences</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Clerico, Marinella</au><au>Artusi, Carlo Alberto</au><au>Liberto, Alessandra Di</au><au>Rolla, Simona</au><au>Bardina, Valentina</au><au>Barbero, Pierangelo</au><au>Mercanti, Stefania Federica De</au><au>Durelli, Luca</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Natalizumab in Multiple Sclerosis: Long-Term Management</atitle><jtitle>International journal of molecular sciences</jtitle><addtitle>Int J Mol Sci</addtitle><date>2017-04-29</date><risdate>2017</risdate><volume>18</volume><issue>5</issue><spage>940</spage><pages>940-</pages><issn>1422-0067</issn><issn>1661-6596</issn><eissn>1422-0067</eissn><abstract>Natalizumab is a monoclonal antibody highly effective in the treatment of relapsing remitting multiple sclerosis (RRMS) patients. Despite its effectiveness, there are growing concerns regarding the risk of progressive multifocal leukoencephalopathy (PML), a brain infection caused by John Cunningham virus (JCV), particularly after 24 doses and in patients who previously received immunosuppressive drugs. Long-term natalizumab treated, immunosuppressive-pretreated, and JCV antibody-positive patients are asked to rediscuss natalizumab continuation or withdrawal after 24 doses. Until now, there has not been a clear strategy that should be followed to avoid PML risk and in parallel reduce clinical and radiological rebound activity. In this review, we analyzed the results of clinical trials and case reports in relation to the following situations: natalizumab continuation, natalizumab discontinuation followed by full therapeutic suspension or switch to other first or second line MS treatments. Quitting all MS treatment after natalizumab increases MS activity occurrence. The results regarding the therapeutic switch are not homogeneous, so at the moment there are no established guidelines regarding natalizumab treatment after 24 administrations; the choice is currently based on the professional experience of the neurologist, and on patients' clinical features and preferences.</abstract><cop>Switzerland</cop><pub>MDPI AG</pub><pmid>28468254</pmid><doi>10.3390/ijms18050940</doi><orcidid>https://orcid.org/0000-0002-6371-7354</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1422-0067 |
| ispartof | International journal of molecular sciences, 2017-04, Vol.18 (5), p.940 |
| issn | 1422-0067 1661-6596 1422-0067 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5454853 |
| source | MEDLINE; MDPI - Multidisciplinary Digital Publishing Institute; EZB-FREE-00999 freely available EZB journals; PubMed Central |
| subjects | Adrenal Cortex Hormones - therapeutic use Animals Antibodies, Monoclonal - administration & dosage Antibodies, Monoclonal - adverse effects Antibodies, Monoclonal - therapeutic use Case reports Clinical trials Drugs Encephalitis Humans Immunologic Factors - administration & dosage Immunologic Factors - adverse effects Immunologic Factors - therapeutic use Immunosuppressive agents Immunotherapy JC Virus - isolation & purification Leukoencephalopathy Leukoencephalopathy, Progressive Multifocal - diagnosis Leukoencephalopathy, Progressive Multifocal - etiology Medical research Monoclonal antibodies Multiple sclerosis Multiple Sclerosis - drug therapy Natalizumab - administration & dosage Natalizumab - adverse effects Natalizumab - therapeutic use Patients Progressive multifocal leukoencephalopathy Review Risk Viral infections |
| title | Natalizumab in Multiple Sclerosis: Long-Term Management |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-24T21%3A14%3A46IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Natalizumab%20in%20Multiple%20Sclerosis:%20Long-Term%20Management&rft.jtitle=International%20journal%20of%20molecular%20sciences&rft.au=Clerico,%20Marinella&rft.date=2017-04-29&rft.volume=18&rft.issue=5&rft.spage=940&rft.pages=940-&rft.issn=1422-0067&rft.eissn=1422-0067&rft_id=info:doi/10.3390/ijms18050940&rft_dat=%3Cproquest_pubme%3E1910599182%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1910599182&rft_id=info:pmid/28468254&rfr_iscdi=true |