A recent multicentre study has assessed the risk of relapse in patients with multiple sclerosis who switched from natalizumab to fingolimod treatment. Despite such efforts, no effective exit strategy from natalizumab treatment has yet been demonstrated for these patients.
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Cohen, M. et al. Switching from natalizumab to fingolimod in multiple sclerosis: a French prospective study. JAMA Neurol. 71, 436–441 (2014).
O'Connor, P. W. et al. Disease activity return during natalizumab treatment interruption in patients with multiple sclerosis. Neurology 76, 1858–1865 (2011).
Jokubaitis, V. G. et al. Fingolimod after natalizumab and the risk of short-term relapse. Neurology 82, 1204–1211 (2014).
Kappos, L. et al. Disease control and safety in relapsing–remitting multiple sclerosis (RRMS) patients switching from natalizumab to fingolimod: a 32-week, rater- and patient-blind, randomized, parallel-group study (TOFINGO). Mult. Scler. 19 (Suppl. 1), 50 (2013).
Bloomgren, G. et al. Risk of natalizumab-associated progressive multifocal leukoencephalopathy. N. Engl. J. Med. 366, 1870–1880 (2012).
Krumbholz, M., Meinl, I., Kümpfel, T., Hohlfeld, R. & Meinl, E. Natalizumab disproportionately increases circulating pre-B and B cells in multiple sclerosis. Neurology 71, 1350–1354 (2008).
Kivisakk, P. et al. Natalizumab treatment is associated with peripheral sequestration of proinflammatory T cells. Neurology 72, 1922–1930 (2009).
Fine, A. J., Sorbello, A., Kortepeter, C. & Scarazzini, L. Progressive multifocal leukoencephalopathy after natalizumab discontinuation. Ann. Neurol. 75, 108–115 (2014).
Stüve, O. et al. Immunologic, clinical, and radiologic status 14 months after cessation of natalizumab therapy. Neurology 72, 396–401 (2009).
Brinkmann, V. et al. The immune modulator FTY720 targets sphingosine 1-phosphate receptors. J. Biol. Chem. 277, 21453–21457 (2002).
M.S. has received honoraria or consultancy payments from Bayer Healthcare, Biogen Idec, Baxter, CSL Behring, Grifols, Merck-Serono, Novartis, Sanofi-Aventis, and Teva. His institution has received research support from Bayer Healthcare, Biogen Idec, Merck-Serono, Novartis, and Teva. O.S. declares no competing interests.
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Stangel, M., Stüve, O. Natalizumab to fingolimod—the washout whitewash. Nat Rev Neurol 10, 311–313 (2014). https://doi.org/10.1038/nrneurol.2014.82
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