Search research articles

ABOUT JoVE

Overview Leadership Blog JoVE Help Center

AUTHORS

Publishing Process Editorial Board Scope & Policies Peer Review FAQ Submit

LIBRARIANS

Testimonials Subscriptions Access Resources Library Advisory Board FAQ

RESEARCH

JoVE Journal Methods Collections JoVE Encyclopedia of Experiments Archive

EDUCATION

JoVE Core JoVE Business JoVE Science Education JoVE Lab Manual Faculty Resource Center Faculty Site

Terms & Conditions of Use

Related Concept Videos

Multiple Sclerosis l: Introduction

Multiple Sclerosis l: Introduction

Multiple sclerosis is a chronic autoimmune disease of the central nervous system (CNS) that affects the brain, spinal cord, and optic nerves. It is an inflammatory demyelinating disorder and a leading cause of neurological disability in young adults.EpidemiologyMS commonly begins between 20 and 40 years of age and is twice as common in women. Its exact cause remains unclear, but genetic susceptibility contributes, with higher risk in first-degree relatives and identical twins. A greater...

Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents

Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents

Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel Disease...

Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF

Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF

Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab (Humira),...

Search research articles

Home
Effect Of Prior Treatment With Fingolimod On Early And Late Response To Rituximab/ocrelizumab In Patients With Multiple Sclerosis

Home
Effect Of Prior Treatment With Fingolimod On Early And Late Response To Rituximab/ocrelizumab In Patients With Multiple Sclerosis

Related Experiment Video

Author Spotlight: Novel Assay for Studying B-Cell Responses in Multiple Sclerosis Research

Author Spotlight: Novel Assay for Studying B-Cell Responses in Multiple Sclerosis Research

Published on: December 1, 2023

Effect of Prior Treatment With Fingolimod on Early and Late Response to Rituximab/Ocrelizumab in Patients With

Lisa Graille-Avy¹, Clemence Boutiere¹, Camille Rigollet¹

¹From the APHM (L.G.-A., C.B., C.R., M.P., A.R., S.D., F.H., J.P., A.M., B.A.), Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; Aix-Marseille University (A.R., J.P., A.M., B.A.), CNRS, CRMBM, Marseille; Centre hospitalier d'Ajaccio (P.D.), Service de Neurologie, Ajaccio; APHM (F.V.), Hôpital de la Timone, Service d'immunologie, Marseille Immunopôle; Aix Marseille University (F.V.), CNRS, INSERM, CIML; and APHM (P.B.-P.), Hôpital de la Timone, Service Pharmacie, Marseille, France.

Neurology(R) Neuroimmunology & Neuroinflammation

|April 16, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

Switching to rituximab or ocrelizumab after fingolimod may increase relapse risk in multiple sclerosis (MS) within six months if the washout period exceeds 26 days. Effectiveness of these therapies is not impacted by prior treatments beyond six months.

More Related Videos

Determining Immune System Suppression versus CNS Protection for Pharmacological Interventions in Autoimmune Demyelination

Determining Immune System Suppression versus CNS Protection for Pharmacological Interventions in Autoimmune Demyelination

Published on: September 12, 2016

A Method of Trigonometric Modelling of Seasonal Variation Demonstrated with Multiple Sclerosis Relapse Data

A Method of Trigonometric Modelling of Seasonal Variation Demonstrated with Multiple Sclerosis Relapse Data

Published on: December 9, 2015

Related Experiment Videos

Author Spotlight: Novel Assay for Studying B-Cell Responses in Multiple Sclerosis Research

Author Spotlight: Novel Assay for Studying B-Cell Responses in Multiple Sclerosis Research

Published on: December 1, 2023

Determining Immune System Suppression versus CNS Protection for Pharmacological Interventions in Autoimmune Demyelination

Determining Immune System Suppression versus CNS Protection for Pharmacological Interventions in Autoimmune Demyelination

Published on: September 12, 2016

A Method of Trigonometric Modelling of Seasonal Variation Demonstrated with Multiple Sclerosis Relapse Data

A Method of Trigonometric Modelling of Seasonal Variation Demonstrated with Multiple Sclerosis Relapse Data

Published on: December 9, 2015

Area of Science:

Neurology
Immunology

Background:

Real-world evidence suggests varied disease activity risks when switching multiple sclerosis (MS) patients to rituximab (RTX) or ocrelizumab (OCR).
Fingolimod (FING) as a prior disease-modifying therapy (DMT) is associated with a potentially higher risk of MS disease activity post-switch.

Purpose of the Study:

To investigate the impact of prior DMTs on RTX/OCR effectiveness in relapsing MS.
To determine if fingolimod washout duration influences RTX/OCR efficacy and safety.

Main Methods:

Retrospective analysis of 321 relapsing MS patients treated with RTX/OCR.
Cox proportional hazards models were used to analyze clinical and MRI outcomes.
Patients were categorized by prior DMT, including fingolimod (short vs. long washout), natalizumab, and low-efficacy therapies.

Main Results:

A significantly increased risk of relapse within 6 months of RTX/OCR initiation was observed in patients switching from fingolimod with a washout period exceeding 26 days (HR: 8.78).
Prior DMTs did not affect B-cell levels at 6 months.
Beyond 6 months, younger age (<40), male sex, and higher EDSS (≥2) were associated with increased relapse risk, new T2 lesions, and disability accumulation, respectively.
Prior DMTs did not impact RTX/OCR effectiveness after the initial 6-month period.

Conclusions:

Extended fingolimod washout periods (>26 days) before switching to RTX/OCR are linked to higher early relapse risk in MS patients.
The effectiveness of RTX/OCR in MS patients is not diminished by prior fingolimod or other DMTs beyond the initial six months of treatment.