Safety and effectiveness of disease-modifying therapies after switching from natalizumab.

Autor:	Zeineddine M; Inserm U1094, IRD U270, Univ. Limoges, CHU Limoges, EpiMaCT-Epidemiology of chronic diseases in tropical zone, Institute of Epidemiology and Tropical Neurology, Omega Health, Limoges, France.; School of Pharmacy, Lebanese American University, Byblos, Lebanon., Al-Roughani R; Al-Amiri Hospital, Kuwait City, Kuwait., Farouk Ahmed S; Ibn Sina Hospital, Kuwait City, Kuwait., Khoury S; American University of Beirut Medical Center, Nehme and Therese Tohme Multiple Sclerosis Center, Beirut, Lebanon., El-Ayoubi N; American University of Beirut Medical Center, Nehme and Therese Tohme Multiple Sclerosis Center, Beirut, Lebanon., Al-Mahdawi A; Baghdad Medical City Teaching Hospital, Baghdad, Iraq., Al-Khabouri J; Department of Neurology, The Royal Hospital, Muscat, Oman., Al-Asmi A; Neurology Unit, Department of Medicine, College of Medicine and Health Sciences and Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman., Chentouf A; Neurology Department, University Hospital Center, Oran, Algeria., Inshasi J; MS Department, Rashid Hospital and Dubai Medical College, Dubai Health Authority, Dubai, United Arab Emirates., Gouider R; Department of Neurology, LR18SP03, Clinical Investigation Center 'Neurosciences and Mental Health,' Razi University Hospital-Manouba, Tunis, Tunisia., Mrabet S; Department of Neurology, LR18SP03, Clinical Investigation Center 'Neurosciences and Mental Health,' Razi University Hospital-Manouba, Tunis, Tunisia., Shalaby N; Neurology Department, Kasr Alainy School of Medicine, Cairo University, Cairo, Egypt., Massouh J; Neurology Institute and MS Center, Harley Street Medical Center, Abu Dhabi, United Arab Emirates., Mohamed Ramzy Hasan Mohamed F; Neurology Institute and MS Center, Harley Street Medical Center, Abu Dhabi, United Arab Emirates., Al-Hajje A; Faculty of Pharmacy, Lebanese University, Beirut, Lebanon.; National Institute of Public Health, Clinical Epidemiology and Toxicology (INSPECT-LB), Beirut, Lebanon., Salameh P; Faculty of Pharmacy, Lebanese University, Beirut, Lebanon.; National Institute of Public Health, Clinical Epidemiology and Toxicology (INSPECT-LB), Beirut, Lebanon.; School of Medicine, Lebanese American University, Byblos, Lebanon; Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus., Dimassi H; Faculty of Pharmacy, Lebanese University, Beirut, Lebanon.; National Institute of Public Health, Clinical Epidemiology and Toxicology (INSPECT-LB), Beirut, Lebanon.; School of Medicine, Lebanese American University, Byblos, Lebanon; Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus., Boumediene F; Inserm U1094, IRD U270, Univ. Limoges, CHU Limoges, EpiMaCT-Epidemiology of chronic diseases in tropical zone, Institute of Epidemiology and Tropical Neurology, Omega Health, Limoges, France., Yamout B; Neurology Institute and MS Center, Harley Street Medical Center, Abu Dhabi, United Arab Emirates.
Jazyk:	angličtina
Zdroj:	Multiple sclerosis (Houndmills, Basingstoke, England) [Mult Scler] 2024 Jul; Vol. 30 (8), pp. 1026-1035. Date of Electronic Publication: 2024 Jul 26.
DOI:	10.1177/13524585241261565
Abstrakt:	Introduction: One strategy to mitigate progressive multifocal leukoencephalopathy (PML) risk is to switch to other highly effective disease-modifying therapies (DMTs). However, the optimal switch DMT following natalizumab (NTZ) discontinuation is yet to be determined. Objective: The objective of the study is to determine the most effective and tolerable DMTs to switch to following NTZ discontinuation due to John Cunningham virus (JCV) antibody positivity. Methods: This is a multicenter observational cohort study that included all stable relapsing-remitting multiple sclerosis (MS) patients who were treated with NTZ for at least 6 months before switching therapy due to JCV antibody positivity. Results: Of 321 patients, 255 switched from NTZ to rituximab/ocrelizumab, 52 to fingolimod, and 14 to alemtuzumab, with higher annualized relapse rate (ARR) in fingolimod switchers (0.193) compared with rituximab/ocrelizumab or alemtuzumab (0.028 and 0.032, respectively). Fingolimod switchers also had increased disability progression ( p = 0.014) and a higher proportion developed magnetic resonance imaging (MRI) lesions compared with rituximab/ocrelizumab (62.9% vs. 13.0%, p < 0.001, and 66.6% vs. 24.0%, p < 0.001, respectively). Mean drug survival favored rituximab/ocrelizumab or alemtuzumab over fingolimod ( p < 0.001). Conclusion: Our study shows superior effectiveness of rituximab/ocrelizumab and alemtuzumab compared with fingolimod in stable patients switching from NTZ due to JC virus antibody positivity. Competing Interests: Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: M.Z. has received honoraria for lectures from Biologix, Biogen, Janssen, Hikma Pharmaceuticals, Novartis, Merck, Roche, and Sanofi-Genzyme. She received travel grants from Novartis, Merck, and Roche and a research grant from Biogen. She received two research grants from Biogen, one research grant from Merck, and two research grants from MENACTRIMS. She has no conflict of interest related to this study. B.Y. has received speaker honoraria from Bayer, Biogen, Merck, Novartis, Roche, and Sanofi; research grants from Bayer, Biogen, Merck, Novartis, and Pfizer; and advisory board honoraria from Bayer, Biogen, Merck, Novartis, Roche, and Sanofi. He has no conflict of interest related to this study. A.A.-A. has received honoraria from Novartis, Sanofi, Biologix, Merck, Roche, Biogen, and Bayer. He serves on the scientific advisory boards of Novartis, Merck, and Roche. He has no conflict of interest related to this study. R.G. has received research grant from Roche and advisory board honoraria from Biogen, Hikma, Merck, Roche, and Sanofi. He has no conflict of interest related to this study. S.M. received a MENACTRIMS clinical research grant (2020) but has no conflict of interest related to this study. R.A.-R., S.F.A., S.K., N.E.-A., A.A.-M., J.A.-K., A.C., J.I., N.S., J.M., F.M.R.H.M., A.A.-H., P.S., H.D., and F.B. declare that there is no conflict of interest.
Databáze:	MEDLINE
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