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Stopping Natalizumab Causes Inflammatory Rebound in MS

Last Updated: October 12, 2010.

Some multiple sclerosis (MS) patients who discontinue natalizumab therapy may experience a rebound of disease activity, according to research published online Oct. 11 in the Archives of Neurology.

TUESDAY, Oct. 12 (HealthDay News) -- Some multiple sclerosis (MS) patients who discontinue natalizumab therapy may experience a rebound of disease activity, according to research published online Oct. 11 in the Archives of Neurology.

Augusto Miravalle, M.D., of the University of Colorado Denver, and colleagues observed 32 MS patients who had received at least 12 consecutive infusions of natalizumab to assess the effect of temporary suspension of the treatment during a three- to four-month treatment holiday.

Relapses were experienced during interruption of natalizumab therapy or shortly after resumption of therapy by 38 percent of patients with relapsing-remitting MS (nine of 24) and secondary progressive MS (three of eight); magnetic resonance imaging revealed widespread evidence of inflammatory activity in some patients with secondary progressive MS who had greater inflammatory disease activity before starting therapy. Relapses tended to occur more frequently in younger patients who had received fewer treatments before suspension of therapy. Restarting natalizumab therapy resulted in resumption of prior disease control in all patients.

"In this cohort of patients with MS who had disease refractive to multiple therapeutics before starting natalizumab treatment, magnetic resonance imaging and clinical disease activity returned, often aggressively, following discontinuation of natalizumab therapy. These findings suggest we should consider strategies to minimize the risk of immune reconstitution inflammatory syndrome after natalizumab discontinuation," the authors write.

Two authors disclosed financial relationships with pharmaceutical companies, including Biogen Idec, which markets natalizumab.

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