Abstract Details

Title Natalizumab Exit Strategy Experience with Fingolimod

Topic MS and Related Diseases

Presentation(s) P01 - (-)

Poster/Presentation
Number 206

Objective

Background BACKGROUND: Natalizumab therapy is an effective option in the treatment of relapsing multiple sclerosis, yet some patients opt to change therapy for various reasons. A common reason for exit is having a positive JCV antibody status. A convincingly effective exit strategy that minimizes risk of JCV-induced PML and/or prevents recurrent MS disease activity has not been demonstrated.

Design/Methods DESIGN/METHODS: Seventy five patients with relapsing MS who have switched from natalizumab to fingolimod therapy at the JPL MS Center have been followed for at least 6 months following this switch. Persistence on therapy, cranial MRI disease activity, relapses, and EDSS status have been followed.

Results RESULTS: Seventy five patients were started on fingolimod therapy as the next disease modifying agent after natalizumab. Only 2 patients demonstrated disease activity manifested by relapse and MRI advancement. Two additional patients demonstrated EDSS progression without relapse or MRI advancement. Approximately one fourth of the patients have discontinued fingolimod therapy.

Conclusions CONCLUSIONS: This presentation demonstrates that fingolimod therapy has been the most effective exit strategy from natalizumab of any disease modifying agent with regard to disease progression in a relatively large population at an MS Center. Reasons why a substantial percentage of patients have discontinued therapy are discussed.

Authors/Disclosures
Christopher C. LaGanke, MD (North Central Neurology Associates, PC) PRESENTER	Dr. LaGanke has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EMD Serono. Dr. LaGanke has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Dr. LaGanke has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Biogen. Dr. LaGanke has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Sanofi. Dr. LaGanke has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Novartis. Dr. LaGanke has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for GSK. Dr. LaGanke has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Serono EMD. Dr. LaGanke has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Genentech. Dr. LaGanke has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Bristol Myers Squibb. Dr. LaGanke has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for TG Therapeutics.
Ahmed Enayetallah, PhD, MBBCh (BlueRock Therapeutics)	Dr. Enayetallah has received personal compensation for serving as an employee of Alexion. Dr. Enayetallah has received stock or an ownership interest from Alexion. Dr. Enayetallah has received stock or an ownership interest from AstraZeneca.
	No disclosure on file

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