caa a22 4500 445809051 CHVBK 20180317145205.0 cr unu---uuuuu 170323e20111001xx s 000 0 eng 10.1007/s00415-011-6019-8 doi (NATIONALLICENCE)springer-10.1007/s00415-011-6019-8 Pulsed steroids followed by glatiramer acetate to prevent inflammatory activity after cessation of natalizumab therapy: a prospective, 6-month observational study [Elektronische Daten] [María Magraner, Francisco Coret, Arantxa Navarré, Isabel Boscá, María Simó, Matilde Escutia, Ana Bernad, Laura Navarro, Bonaventura Casanova] In this study, the tolerability and safety of treatment with pulsed steroids and glatiramer acetate and the occurrence of clinical and radiological activity after natalizumab (NTZ) cessation in multiple sclerosis (MS) patients were assessed. MS patients with NTZ were discontinued after 2years of treatment, or if adverse events or disease progressed during NTZ. They were offered as alternative treatment 1 g methylprednisolone per month during 3months followed by daily 20 mcg glatiramer acetate and were prospectively studied. Adverse events, occurrence of immune reconstitution inflammatory syndrome, clinical exacerbations, and gadolinium-enhancing lesions in MRI performed at 3 and 6months after NTZ cessation were recorded. EDSS change during follow-up was also recorded. A total of 18 MS patients entered the study and were followed up for a mean of 10months (range 6-18months). There were no significant adverse events. At month 3, no patient had clinical or radiological disease activity. At month 6, 16.6% of patients had had a relapse and 55.5% of patients showed gadolinium-enhancing lesions in the MRI. After 6months, 33.3% of patients had a further relapse. There was no IRIS, severe relapses, or significant difference between EDSS at NTZ discontinuation and after follow-up. The alternative treatment with monthly prednisolone followed by GA prevents the development of IRIS, but not the return to previous inflammatory activity, which occurs between 5 and 6months after NTZ withdrawal. Springer-Verlag, 2011 Natalizumab nationallicence Drug holidays nationallicence Pulses of steroids nationallicence Magraner María Multiple Sclerosis Unit, Hospital Universitari I Politècnic La Fe, Valencia, Bulevar Sur s/n, 46026, Valencia, Spain aut Coret Francisco Multiple Sclerosis Unit, Hospital Clínico Valencia, Valencia, Spain aut Navarré Arantxa Multiple Sclerosis Unit, Hospital Clínico Valencia, Valencia, Spain aut Boscá Isabel Multiple Sclerosis Unit, Hospital Universitari I Politècnic La Fe, Valencia, Bulevar Sur s/n, 46026, Valencia, Spain aut Simó María Multiple Sclerosis Unit, Hospital Universitari I Politècnic La Fe, Valencia, Bulevar Sur s/n, 46026, Valencia, Spain aut Escutia Matilde Multiple Sclerosis Unit, Hospital Universitari I Politècnic La Fe, Valencia, Bulevar Sur s/n, 46026, Valencia, Spain aut Bernad Ana Multiple Sclerosis Unit, Hospital Clínico Valencia, Valencia, Spain aut Navarro Laura Multiple Sclerosis Unit, Hospital Universitari I Politècnic La Fe, Valencia, Bulevar Sur s/n, 46026, Valencia, Spain aut Casanova Bonaventura Multiple Sclerosis Unit, Hospital Universitari I Politècnic La Fe, Valencia, Bulevar Sur s/n, 46026, Valencia, Spain aut Journal of Neurology Springer-Verlag 258/10(2011-10-01), 1805-1811 0340-5354 258:10<1805 2011 258 415 https://doi.org/10.1007/s00415-011-6019-8 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00415-011-6019-8 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Magraner María Multiple Sclerosis Unit, Hospital Universitari I Politècnic La Fe, Valencia, Bulevar Sur s/n, 46026, Valencia, Spain aut NATIONALLICENCE 700 1- Coret Francisco Multiple Sclerosis Unit, Hospital Clínico Valencia, Valencia, Spain aut NATIONALLICENCE 700 1- Navarré Arantxa Multiple Sclerosis Unit, Hospital Clínico Valencia, Valencia, Spain aut NATIONALLICENCE 700 1- Boscá Isabel Multiple Sclerosis Unit, Hospital Universitari I Politècnic La Fe, Valencia, Bulevar Sur s/n, 46026, Valencia, Spain aut NATIONALLICENCE 700 1- Simó María Multiple Sclerosis Unit, Hospital Universitari I Politècnic La Fe, Valencia, Bulevar Sur s/n, 46026, Valencia, Spain aut NATIONALLICENCE 700 1- Escutia Matilde Multiple Sclerosis Unit, Hospital Universitari I Politècnic La Fe, Valencia, Bulevar Sur s/n, 46026, Valencia, Spain aut NATIONALLICENCE 700 1- Bernad Ana Multiple Sclerosis Unit, Hospital Clínico Valencia, Valencia, Spain aut NATIONALLICENCE 700 1- Navarro Laura Multiple Sclerosis Unit, Hospital Universitari I Politècnic La Fe, Valencia, Bulevar Sur s/n, 46026, Valencia, Spain aut NATIONALLICENCE 700 1- Casanova Bonaventura Multiple Sclerosis Unit, Hospital Universitari I Politècnic La Fe, Valencia, Bulevar Sur s/n, 46026, Valencia, Spain aut NATIONALLICENCE 773 0- Journal of Neurology Springer-Verlag 258/10(2011-10-01), 1805-1811 0340-5354 258:10<1805 2011 258 415 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer