Real-world treatment outcomes and safety of natalizumab in Finnish multiple sclerosis patients

Auli Verkkoniemi-Ahola, Päivi Hartikainen, Katja Hassi, Hanna Kuusisto, Sanni Lahdenperä, Juha Mehtälä, Matias Viitala, Tero Ylisaukko-oja, Merja Soilu-Hänninen

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Abstract

Objectives: The primary objective was to evaluate long-term treatment persistence and safety of natalizumab in Finnish multiple sclerosis patients. The secondary objectives were to assess patient characteristics, use of natalizumab-related safety protocol, and treatment persistence in patients with different anti-John Cunningham virus antibody statuses (John Cunningham virus status). Materials & Methods: All adult multiple sclerosis patients in the Finnish multiple sclerosis register who started natalizumab between 1/2006 and 12/2018 were included in this study and followed retrospectively until treatment discontinuation or end of follow-up (12/2019). Results: In total, 850 patients were included. Median duration of natalizumab treatment was 7.8 years in John Cunningham virus negative (n = 229) and 2.1 years in John Cunningham virus positive patients (n = 115; p < 0.001). The most common cause for treatment discontinuation was John Cunningham virus positivity. After natalizumab discontinuation, patients who had a washout duration of less than 6 weeks had fewer relapses during the first 6 months (p = 0.012) and 12 months (p = 0.005) compared with patients who had a washout duration of over 6 weeks. During the median follow-up of 3.6 years, 76% of patients remained stable or improved on their Expanded Disability Status Scale. Conclusions: Treatment persistence was very high among John Cunningham virus negative patients. The study supports long-term effectiveness of natalizumab and a washout duration of less than 6 weeks after discontinuation.

Original languageEnglish
Number of pages7
JournalMultiple sclerosis journal, experimental, translational and clinical
Volume9
Issue number4
DOIs
Publication statusPublished - Oct 2023
Publication typeA1 Journal article-refereed

Keywords

  • clinical decision-making
  • duration of therapy
  • John Cunningham virus
  • Multiple sclerosis
  • natalizumab
  • retrospective studies

Publication forum classification

  • Publication forum level 1

ASJC Scopus subject areas

  • Clinical Neurology
  • Cellular and Molecular Neuroscience

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