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| Item Type: | Article |
|---|---|
| Title: | Failure of natalizumab to prevent relapses in neuromyelitis optica |
| Creators Name: | Kleiter, I., Hellwig, K., Berthele, A., Kuempfel, T., Linker, R.A., Hartung, H.P., Paul, F. and Aktas, O. |
| Abstract: | Objective: To describe first experiences with the integrin inhibitor natalizumab, given to patients with suspected relapsing-remitting multiple sclerosis (MS) who were later diagnosed with aquaporin 4–positive neuromyelitis optica (NMO). Design: Retrospective case series. Setting: Neurology departments at tertiary referral centers in Germany. Patients: Patients with NMO who tested positive for antibodies to aquaporin 4. Intervention: Treatment with natalizumab. Main Outcome Measures: Relapses and accumulation of disability. Results: We identified 5 patients (4 female; median age, 45 years) who were initially diagnosed with MS and treated with natalizumab before diagnosis of NMO was established. Natalizumab was given as escalation therapy after failure of first- or second-line immunomodulatory therapies for MS. During natalizumab therapy (median duration, 8 infusions; range, 2-11 infusions), all 5 patients displayed persisting disease activity; a total of 9 relapses occurred (median duration to relapse, 120 days; range, 45-230 days) after the start of treatment. Four patients had an accumulation of disability and 1 patient died 2 months after cessation of natalizumab treatment. Conclusions: Our results suggest that natalizumab fails to control disease activity in patients with NMO. Neuromyelitis optica should be considered as a differential diagnosis in patients with suspected MS who are unresponsive to natalizumab therapy. |
| Keywords: | Aquaporin 4, Autoantibodies, Disability Evaluation, Humanized Monoclonal Antibodies, Natalizumab, Neuromyelitis Optica, Relapsing-Remitting Multiple Sclerosis, Secondary Prevention, Treatment Failure, Treatment Outcome |
| Source: | Archives of Neurology |
| ISSN: | 0003-9942 |
| Volume: | 69 |
| Number: | 2 |
| Page Range: | 239-245 |
| Date: | February 2012 |
| Official Publication: | https://doi.org/10.1001/archneurol.2011.216 |
| PubMed: | View item in PubMed |
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