Relapse risk after switching from natalizumab (Tysabri) to fingolimod (Gilenya):
In another study, researchers collected data from patients with MS (n=333) who were switching from natalizumab (Tysabri) to fingolimod (Gilenya) after a mean of 31 natalizumab infusions (female to male ratio, 2.36; mean age, 41 years; 71% were JCV positive). Data was collected regarding treatment with Tysabri, the duration and management of the washout period (WP) after stopping Tysabri, and any relapses or adverse events occurring during the WP and during the 6 months after patients started Gilenya.
During the washout period, 27% of patients relapsed. The risk for relapse was 3.2 times higher for patients who stopped natalizumab because of poor tolerance or lack of efficacy. Washout periods shorter than 3 months were associated with 77% lower risk of relapse during the WP, but also with less disease activity before natalizumab treatment. Twenty percent (20%) of patients relapsed during the first 6 months of treatment with fingolimod, while 3% stopped fingolimod due to issues with efficacy, tolerance, or compliance. Researchers found that the occurrence of relapse during the WP was the only significant prognostic factor for relapse during fingolimod therapy (odds ratio, 3.80; P = .05). They also recommend that washout periods should be shorter than 3 months (Cohen, 2014).
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Hot Topics and MS Research News: February 2014