Switching multiple sclerosis patients with breakthrough disease to second-line therapy

Multiple sclerosis (MS) patients with breakthrough disease on immunomodulatory drugs are frequently offered to switch to natalizumab or immunosuppressants. The effect of natalizumab monotherapy in patients with breakthrough disease is unknown. This is an open-label retrospective cohort study of 993...

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Bibliographic Details
Published in:PloS one 2011-02, Vol.6 (2), p.e16664-e16664
Main Authors: Castillo-Trivino, Tamara, Mowry, Ellen M, Gajofatto, Alberto, Chabas, Dorothee, Crabtree-Hartman, Elizabeth, Cree, Bruce A, Goodin, Douglas S, Green, Ari J, Okuda, Darin T, Pelletier, Daniel, Zamvil, Scott S, Vittinghoff, Eric, Waubant, Emmanuelle
Format: Article
Language:English
Subjects:
Adult
Algorithms
Analysis
Antibodies, Monoclonal - therapeutic use
Antibodies, Monoclonal, Humanized
Care and treatment
Chemotherapy, Adjuvant
Clinical trials
Cohort analysis
Cohort Studies
Disease Progression
Drug dosages
Drug Substitution - methods
Drugs
Female
Humans
Immunologic Factors - therapeutic use
Immunomodulation
Immunosuppressive agents
Immunosuppressive Agents - therapeutic use
Interferon
Leukemia
Male
Medical research
Medicine
Middle Aged
Monoclonal antibodies
Multiple sclerosis
Multiple Sclerosis, Relapsing-Remitting - drug therapy
Multiple Sclerosis, Relapsing-Remitting - pathology
Natalizumab
Neurology
Patients
Poisson density functions
Recurrence
Regression analysis
Retrospective Studies
Rheumatoid arthritis
Statistical analysis
Switching
Therapy
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Summary:Multiple sclerosis (MS) patients with breakthrough disease on immunomodulatory drugs are frequently offered to switch to natalizumab or immunosuppressants. The effect of natalizumab monotherapy in patients with breakthrough disease is unknown. This is an open-label retrospective cohort study of 993 patients seen at least four times at the University of California San Francisco MS Center, 95 had breakthrough disease on first-line therapy (60 patients switched to natalizumab, 22 to immunosuppressants and 13 declined the switch [non-switchers]). We used Poisson regression adjusted for potential confounders to compare the relapse rate within and across groups before and after the switch. In the within-group analyses, the relapse rate decreased by 70% (95% CI 50,82%; p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0016664