Abstract Details

Title Persistence of Cerebrospinal Fluid Oligoclonal Bands after Natalizumab Treatment in Multiple Sclerosis Patients

Topic MS and Related Diseases

Presentation(s) P05 - (-)

Poster/Presentation
Number 187

Objective

Background BACKGROUND: Previous research has indicated that multiple immune modifying treatments have not had an impact on the presence of OCBs. Recently, Glehn et al (2012) reported on the disappearance of OCBs in 4 out of 6 patients treated with natalizumab after a mean of ten infusions. We investigated the validity of this report in patients receiving natalizumab at our center.

Design/Methods DESIGN/METHODS: We analyzed CSF OCBs by isoelectric focusing followed by immunoblotting in 11 clinically definite MS at baseline and after receiving natalizumab. The range of treatment duration was from 6 months to 51 months. All samples were analysed by identical methods and all cases of OCBs in CSF were compared to serum to ensure intrathecal production. In addition, 3 patients who had negative CSF OCBs at baseline were re-examined post-treatment.

Results RESULTS: Following a mean of 23 monthly natalizumab treatments, 9 out of 11 patients remained OCB positive. There were no differences between OCB positive and negative patients in terms of disease subtype, duration of disease, clinical response to natalizumab treatment, or disability scores. Among the 9 OCB positive patients there were no significant differences in the number of OCBs detected in pre-treatment compared to post-treatment samples. Of the 3 OCB-negative patients at baseline, 2 developed detectable bands after 23 and 31 treatment cycles respectively.

Conclusions CONCLUSIONS: Our investigation found that in most patients, CSF oligoclonal banding is not affected by natalizumab treatment. Our results, do not support the previous assertion that natalizumab treatment "converts" OCBs from positive to negative. A probable factor to explain this discrepancy in findings may include analysis of only 6 patients in the previous report. Our analysis is ongoing to include a larger sample of patients.

Authors/Disclosures
James Stark, MD, FAAN (IMSMP) PRESENTER	Dr. Stark has nothing to disclose.
	No disclosure on file
Saud Sadiq, BS, FAAN (Tisch Multiple Sclerosis Research Center of New York)	Ms. Brewi has nothing to disclose.
Jonathan A. Kendter, PharmD (Biogen Idec)	No disclosure on file

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