Natalizumab is a monoclonal antibody highly effective in the treatment of relapsing remitting multiple sclerosis (RRMS) patients. Despite its effectiveness, there are growing concerns regarding the risk of progressive multifocal leukoencephalopathy (PML), a brain infection caused by John Cunningham virus (JCV), particularly after 24 doses and in patients who previously received immunosuppressive drugs. Long-term natalizumab treated, immunosuppressive-pretreated, and JCV antibody-positive patients are asked to rediscuss natalizumab continuation or withdrawal after 24 doses. Until now, there has not been a clear strategy that should be followed to avoid PML risk and in parallel reduce clinical and radiological rebound activity. In this review, we analyzed the results of clinical trials and case reports in relation to the following situations: natalizumab continuation, natalizumab discontinuation followed by full therapeutic suspension or switch to other first or second line MS treatments. Quitting all MS treatment after natalizumab increases MS activity occurrence. The results regarding the therapeutic switch are not homogeneous, so at the moment there are no established guidelines regarding natalizumab treatment after 24 administrations; the choice is currently based on the professional experience of the neurologist, and on patients’ clinical features and preferences.
from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2qg5Pi0
via IFTTT
Εγγραφή σε:
Σχόλια ανάρτησης (Atom)
Δημοφιλείς αναρτήσεις
-
Abstract BACE1 is an indispensable enzyme for generating β-amyloid peptides, which are excessively accumulated in brains of Alzheimer'...
-
Rhinoplasty is perhaps the most challenging and elegant procedure within all of plastic surgery. In this issue of JAMA Facial Plastic Surger...
-
This Viewpoint discusses variances in cardiovascular prevention guidelines from the United States, Europe, and Canada and the debate surroun...
-
Symptom Presentation and Prescription of Sleep Medications for Veterans With Posttraumatic Stress Disorder. J Nerv Ment Dis. 2017 Jan ...
-
Objectives Oral health inequality in children is a widespread and well-documented problem in oral healthcare. However, objective and reliabl...
-
Use of communication coaching that included a question prompt list —or structured lists of questions given to patients prior to consultation...
-
International Journal of Environmental Research... Latest Results for Sleep and BreathingIntermitt... Evolutionary Biology News -- S...
-
Regulatory T cells (Treg) represent a minor sub-population of T lymphocytes which is crucial for the maintenance of immune homeostasis. Here...
-
from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2jleE3p via IFTTT
Δεν υπάρχουν σχόλια:
Δημοσίευση σχολίου