Natalizumab saturation: biomarker for individual treatment holiday after natalizumab withdrawal?. (30th August 2013)

• Record Type: Journal Article
• Authors: Wipfler, P.; Harrer, A.; Pilz, G.; Oppermann, K.; Afazel, S.; Haschke‐Becher, E.; Sellner, J.; Trinka, E.; Kraus, J.
• Is Part Of: Acta neurologica Scandinavica. Volume 129:Number 3(2014:Mar.)
• Page Start: e12
• Page End: e15
• Publication Date: 2013-08-30
• Subjects: Neurology -- Periodicals; 616.8
• DOI: 10.1111/ane.12182
• Languages: English
• ISSNs: 0001-6314

Abstract

<abstract abstract-type="main" id="ane12182-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="ane12182-sec-0001" sec-type="section"> <title>Background</title> <p>More and more patients with multiple sclerosis (MS) switch from natalizumab to fingolimod because of the risk of progressive multifocal leukoencephalopathy. The duration of the treatment holiday is still under debate referring to a possible recurrence of disease activity.</p> </sec> <sec id="ane12182-sec-0002" sec-type="section"> <title>Aim of the study</title> <p>The aim of this study was to evaluate the prognostic value of natalizumab saturation on T cells for the recurrence of clinical and radiological disease activity.</p> </sec> <sec id="ane12182-sec-0003" sec-type="section"> <title>Methods</title> <p>Cell surface‐bound natalizumab saturation (in%) of CD8+ and CD4+ T cells from five patients with MS was determined before initiation of fingolimod by flow cytometry and related to clinical and MRI outcome during a 6‐month follow‐up.</p> </sec> <sec id="ane12182-sec-0004" sec-type="section"> <title>Results</title> <p>In two patients with either clinical or radiological disease activity, the natalizumab saturation on CD8+ and CD4+ T cells was <30%. In contrast, the remaining three patients with absence of disease activity had a median natalizumab saturation of 70% (range 59–79%) on CD4+ and 66% (range 52–68%) on CD8+ T cells.</p> </sec> <sec id="ane12182-sec-0005" sec-type="section"> <title>Conclusions</title> <p>The data of this pilot study indicate that clinical and radiological disease activity is closely linked to natalizumab saturation at the time point of switch. The determination of natalizumab saturation may be an essential tool to monitor cessation of natalizumab treatment.</p> </sec> </abstract>