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Natalizumab extended interval dosing: what about wearing-off effect?
Catarina Bernardes1, Catarina Fernandes1, Carolina Cunha1
1Neurology Department, Coimbra University Hospital Centre, Coimbra, Portugal.
Journal of the Neurological Sciences
|February 18, 2024
Summary
Extended interval dosing (EID) for multiple sclerosis (MS) patients on natalizumab increased the wearing-off (WO) effect. While relapse rates remained stable, more patients experienced WO, with increased severity and duration, necessitating individualized treatment plans.
Area of Science:
- Neurology
- Immunology
- Pharmacology
Background:
- Multiple sclerosis (MS) patients on natalizumab often experience a wearing-off (WO) effect.
- During the COVID-19 pandemic, MS patients on natalizumab were switched from standard interval dosing (SID) to extended interval dosing (EID) every six weeks.
Purpose of the Study:
- To evaluate the impact of extended interval dosing (EID) on the wearing-off (WO) effect in multiple sclerosis (MS) patients treated with natalizumab.
Main Methods:
- An observational retrospective study was conducted.
- Seventy-six MS patients on natalizumab EID were surveyed about their experience with WO symptoms on both SID and EID.
Main Results:
- No significant difference in annual relapse rates was observed after switching to EID.
- A significant increase in the proportion of patients experiencing WO was noted (38.2% to 56.6%).
- Patients reported increased severity and duration of WO symptoms on EID, with earlier symptom onset.
Conclusions:
- Extended interval dosing (EID) in natalizumab-treated MS patients leads to a higher prevalence, severity, and duration of the wearing-off (WO) effect.
- Individualized treatment approaches are crucial for maintaining clinical effectiveness with EID, as symptom management may require dose adjustments.
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