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Safety and effectiveness of less frequent dosing of natalizumab in relapsing remitting multiple sclerosis (RRMS) patients in a dedicated MS center in Greece - an eleven years experience
Author(s): ,
C. Karageorgiou
Affiliations:
Neurology, Athens Medical Center; Neurological Institute of Athens, Athens, Greece
,
T. Kalamatas
Affiliations:
Neurology, Athens Medical Center; Neurological Institute of Athens, Athens, Greece
,
E. Giannouli
Affiliations:
Neurology, Athens Medical Center; Neurological Institute of Athens, Athens, Greece
,
A. Athanasouli
Affiliations:
Neurology, Athens Medical Center; Neurological Institute of Athens, Athens, Greece
,
A. Kargadou
Affiliations:
Neurology, Athens Medical Center; Neurological Institute of Athens, Athens, Greece
,
V. Sakkou
Affiliations:
Neurology, Athens Medical Center; Neurological Institute of Athens, Athens, Greece
,
E. Karageorgiou
Affiliations:
Neurological Institute of Athens, Athens, Greece; UCSF MAC and Stanford University, San Fransisco, CA, United States
,
F. Roussos
Affiliations:
General Hospital of Athens G. Gennimatas, Athens, Greece
,
M. Grillia
Affiliations:
General Hospital of Athens G. Gennimatas, Athens, Greece
,
G. Tagaris
Affiliations:
General Hospital of Athens G. Gennimatas, Athens, Greece
S. Tsiara
Affiliations:
General Hospital of Athens G. Gennimatas, Athens, Greece
ECTRIMS Online Library. Karageorgiou C. Oct 12, 2018; 229082
Clementine Karageorgiou
Clementine Karageorgiou
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Abstract: P1242

Type: Poster Sessions

Abstract Category: Therapy - Long-term treatment monitoring

Background: Natalizumab (Nat) is a highly effective treatment for RRMS patients with a well-documented risk of progressive multifocal leucoencephalopathy (PML).
Goals: To monitor a total of 750 patients under Nat (2007-2018), the manifestation of PML, and to document whether less frequent Nat dosing (every 45-60 days) was effective and associated with less PML risk.
Methods: 750 RRMS patients under Nat (time period 2007-2018) were included in the study. Patient demographics, prior treatments, JCVindex (data from multiple measurements every 6 months, and proportion of patients who seroconversed), PML incidence, IRIS incidence after Nat discontinuation, proportion of patients with less frequent dosing due to high JCV index (relapse rate, MRI findings, PML incidence) were recorded. In the less frequent dosing group patients with a high JCVindex were included. Clinical examination and brain MRI every 6 months were monitored, as well as JCVindex every 3 months.
Results: 266 patients continue regular dosing Nat treatment (seronegative and low JCVindex). 400 patients changed MS treatment through the years (progressive disease, high JCVindex). 84 patients gave their informed consent to receive less frequent Nat dosing every 45-60 days (high JCVindex and high disease activity - fear of IRIS or disease rebound in possible discontinuation), none of them presented PML (100%) or IRIS or clinical worsening . 7 PML cases were reported before the implementation of less frequent dosing group.
Conclusions: Less frequent Nat dosing appears safe and effective in RRMS patients. The long wash-out period of Natalizumab permits a less frequent drug dosing without side-effects (PML). Frequent monitoring of these patients is mandatory.
Disclosure: Clementine E. Karageorgiou: nothing to disclose for this study
Themistoklis Kalamatas:nothing to disclose for this study
Ermioni Giannouli:nothing to disclose for this study
Asimina Athanasouli:nothing to disclose for this study
Altani Kargadou:nothing to disclose for this study
Vasiliki Sakkou:nothing to disclose for this study
Elissaios Karageorgiou:nothing to disclose for this study
Fotis Roussos:nothing to disclose for this study
Georgios Tagaris:nothing to disclose for this study
Maria Grylia:nothing to disclose for this study
Sofia Tsiara:nothing to disclose for this study

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