title: No impact of current therapeutic strategies on disease reactivation after natalizumab discontinuation: a comparative analysis of different approaches during the first year of natalizumab discontinuation.
abstract: OBJECTIVE
  Natalizumab discontinuation induces the recurrence of multiple sclerosis disease activity: currently no therapeutic approach has been found able to abolish disease reactivation.
  
  
  METHODS
  The recurrence of disease activity after natalizumab discontinuation was retrospectively evaluated in 79 patients who had been treated with immunomodulating agents, other first-line therapies, fingolimod or not treated.
  
  
  RESULTS
  No differences have been found in clinical or magnetic resonance imaging recurrence of disease activity amongst the groups. Interestingly, no disease reactivation was observed only in one patient treated for 6 months with monthly pulses of cyclophosphamide.
  
  
  CONCLUSIONS
  Disease modifying treatment or 'no treatment' is unable to abolish disease activity reactivation after natalizumab discontinuation.
authors.affiliation: Regional Multiple Sclerosis Centre, San Luigi Gonzaga Hospital, Orbassano, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Capobianco
authors.forename: A
authors.initials: A
authors.lastname: di Sapio
authors.forename: M
authors.initials: M
authors.lastname: Malentacchi
authors.forename: S
authors.initials: S
authors.lastname: Malucchi
authors.forename: M
authors.initials: M
authors.lastname: Matta
authors.forename: F
authors.initials: F
authors.lastname: Sperli
authors.forename: A
authors.initials: A
authors.lastname: Bertolotto
mesh_terms: D000328:Adult; D005260:Female; D000068876:Fingolimod Hydrochloride / Q000008:administration & dosage / Q000494:pharmacology*; D005500:Follow-Up Studies; D006801:Humans; D007155:Immunologic Factors / Q000008:administration & dosage / Q000494:pharmacology*; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000494:pharmacology*; D008297:Male; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000188:drug therapy*; D000069442:Natalizumab / Q000008:administration & dosage / Q000494:pharmacology*; D017063:Outcome Assessment, Health Care; D012008:Recurrence; D012189:Retrospective Studies
chemical_list: D007155:Immunologic Factors; D007166:Immunosuppressive Agents; D000069442:Natalizumab; D000068876:Fingolimod Hydrochloride
keywords: disease modifying drugs; disease reactivation; fingolimod; multiple sclerosis; natalizumab; treatment interruption