Effect of Glatiramer acetate on disease reactivation in MS patients discontinuing natalizumab
European Journal of Neurology, 07/11/2012
Rossi S et al. – Following discontinuation of natalizumab, twelve–month therapy with glatiramer acetate (GA) is safe and well tolerated in Multiple Sclerosis (MS) patients. GA can reduce the risk of early reactivation/rebound of disease activity in this setting.Methods
- In the present multi–center, open–label, non–randomized, prospective, pilot study, the authors tested whether treatment with glatiramer acetate (GA) is safe and effective after natalizumab in MS patients.
- The study was performed at academic tertiary medical centers.
- Forty active relapsing–remitting MS patients who never failed GA therapy and who discontinued natalizumab after 12–18 months of therapy were enrolled.
- GA was initiated 4 weeks after the last dose of natalizumab.
- 62.5% of patients were relapse–free 12 months after GA initiation.
- Annualized relapse rate and time to relapse were significantly lower than before natalizumab.
- Notably, the frequency of relapses was significantly lower amongst those patients who had experienced ≤2 relapses the year before initiation of natalizumab therapy, compared with patients who had had three or more relapses.
- No evidence of rebound was observed in MRI scans.
- Furthermore, EDSS and MSFC were stable in the patients, again suggesting that 12 months of post–natalizumab–GA therapy is not associated with clinical deterioration.