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Home / Spectrum / Arch Neurol — Abstract: Failure of Natalizumab to Prevent Relapses in Neuromyelitis Optica, February 2012, Kleiter et al. 69 (2): 239

Arch Neurol — Abstract: Failure of Natalizumab to Prevent Relapses in Neuromyelitis Optica, February 2012, Kleiter et al. 69 (2): 239

Failure of Natalizumab to Prevent Relapses in Neuromyelitis Optica

Ingo Kleiter, MD; Kerstin Hellwig, MD; Achim Berthele, MD; Tania K?mpfel, MD; Ralf A. Linker, MD; Hans-Peter Hartung, MD; Friedemann Paul, MD; Orhan Aktas, MD; for the Neuromyelitis Optica Study Group

Arch Neurol.?2012;69(2):239-245. doi:10.1001/archneurol.2011.216

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.

Read More: Arch Neurol — Abstract: Failure of Natalizumab to Prevent Relapses in Neuromyelitis Optica, February 2012, Kleiter et al. 69 (2): 239

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