Summary
Natalizumab is a new therapy option for people with multiple sclerosis (MS). It has been suggested that natalizumab-associated progressive multifocal leukoencephalopathy may be prevented by structured interruptions of treatment. Although numbers are small the authors concluded that a natalizumab drug holiday without reinstatement of alternate disease-modifying therapy is poorly tolerated. Killestein J, Vennegoor A, Strijbis EM, Seewann A, van Oosten BW, Uitdehaag BM, Polman CH. Ann Neurol. 2010 Jul 26.
Details
It has been suggested that natalizumab-associated progressive
multifocal leukoencephalopathy may be prevented by structured
interruptions of treatment. Evidence supporting such a drug
holiday is not yet available. Authors present initial
observations in 10 multiple sclerosis patients who were
stringently monitored up to 6 months after discontinuation of the
infusions. Cumulatively, a combination of clinical relapse and
new and/or enhanced lesions on magnetic resonance imaging had
occurred in 7 of 10 patients. Although numbers are small, they
conclude that data suggest that in patients who were switched to
natalizumab because of disease activity despite first-line
treatment, a natalizumab drug holiday without reinstatement of
alternate disease-modifying therapy is poorly tolerated.