Gilenya (Fingolimod) reduces recurrence of disease activity after Tysabri (natalizumab) withdrawal
discontinuation of natalizumab (NAT), multiple sclerosis (MS) disease
activity often recurs. We assessed the recurrence of clinical
activity during the first year after switching from NAT to fingolimod
(FTY) in patients with relapsing-remitting MS. The number of relapses
and the annualized relapse rate (ARR) before, during and after NAT
discontinuation were determined and compared between 26 MS patients who
switched to FTY within 24 weeks, and 10 MS patients who remained without
disease modifying therapy (therapy free group = TFG). Most relapses in
the FTY group occurred just before or within 8 weeks after starting FTY.
Our observation suggests that initiation of FTY treatment after NAT
discontinuation reduces the recurrence of disease activity compared to
withdrawal without further immunomodulatory treatment. In the FTY group
the ARR tended to depend on the time interval between discontinuation of
NAT and initiation of FTY.