Efficacy of natalizumab in second line therapy of relapsing–remitting multiple sclerosis: results from a multi‐center study in German speaking countries
Identifieur interne : 000B08 ( Istex/Corpus ); précédent : 000B07; suivant : 000B09Efficacy of natalizumab in second line therapy of relapsing–remitting multiple sclerosis: results from a multi‐center study in German speaking countries
Auteurs : N. Putzki ; O. Yaldizli ; M. M Urer ; S. Cursiefen ; S. Kuckert ; C. Klawe ; M. Maschke ; B. Tettenborn ; V. LimmrothSource :
- European Journal of Neurology [ 1351-5101 ] ; 2010-01.
English descriptors
Abstract
Background: Natalizumab has been recommended for the treatment of relapsing–remitting multiple sclerosis (RRMS) in patients with insufficient response to interferon‐beta/glatiramer acetate (DMT) or aggressive MS. The pivotal trials were not conducted to investigate natalizumab monotherapy in this patient population.
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DOI: 10.1111/j.1468-1331.2009.02728.x
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ISTEX:D7EFE7528A83DCB4231262DC63949199D5BB7990Le document en format XML
<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">Efficacy of natalizumab in second line therapy of relapsing–remitting multiple sclerosis: results from a multi‐center study in German speaking countries</title><author><name sortKey="Putzki, N" sort="Putzki, N" uniqKey="Putzki N" first="N." last="Putzki">N. Putzki</name><affiliation><mods:affiliation>Department of Neurology, University Clinic Essen, University of Duisburg‐Essen, Germany</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Neurology, Cantonal Hospital St. Gallen, St Gallen, Switzerland</mods:affiliation></affiliation></author><author><name sortKey="Yaldizli, O" sort="Yaldizli, O" uniqKey="Yaldizli O" first="O." last="Yaldizli">O. Yaldizli</name><affiliation><mods:affiliation>Department of Neurology, Cantonal Hospital St. Gallen, St Gallen, Switzerland</mods:affiliation></affiliation></author><author><name sortKey="M Urer, M" sort="M Urer, M" uniqKey="M Urer M" first="M." last="M Urer">M. M Urer</name><affiliation><mods:affiliation>Department of Neurology, University Clinic Erlangen, Erlangen, Germany</mods:affiliation></affiliation></author><author><name sortKey="Cursiefen, S" sort="Cursiefen, S" uniqKey="Cursiefen S" first="S." last="Cursiefen">S. Cursiefen</name><affiliation><mods:affiliation>Department of Neurology, University Clinic Erlangen, Erlangen, Germany</mods:affiliation></affiliation></author><author><name sortKey="Kuckert, S" sort="Kuckert, S" uniqKey="Kuckert S" first="S." last="Kuckert">S. Kuckert</name><affiliation><mods:affiliation>Department of Neurology, Cologne City Hospitals, Cologne‐Merheim, Germany</mods:affiliation></affiliation></author><author><name sortKey="Klawe, C" sort="Klawe, C" uniqKey="Klawe C" first="C." last="Klawe">C. Klawe</name><affiliation><mods:affiliation>Department of Neurology, Barmherzige Brueder Hospital, Trier, Germany</mods:affiliation></affiliation></author><author><name sortKey="Maschke, M" sort="Maschke, M" uniqKey="Maschke M" first="M." last="Maschke">M. Maschke</name><affiliation><mods:affiliation>Department of Neurology, Barmherzige Brueder Hospital, Trier, Germany</mods:affiliation></affiliation></author><author><name sortKey="Tettenborn, B" sort="Tettenborn, B" uniqKey="Tettenborn B" first="B." last="Tettenborn">B. 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Putzki</name><affiliation><mods:affiliation>Department of Neurology, University Clinic Essen, University of Duisburg‐Essen, Germany</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Neurology, Cantonal Hospital St. Gallen, St Gallen, Switzerland</mods:affiliation></affiliation></author><author><name sortKey="Yaldizli, O" sort="Yaldizli, O" uniqKey="Yaldizli O" first="O." last="Yaldizli">O. Yaldizli</name><affiliation><mods:affiliation>Department of Neurology, Cantonal Hospital St. Gallen, St Gallen, Switzerland</mods:affiliation></affiliation></author><author><name sortKey="M Urer, M" sort="M Urer, M" uniqKey="M Urer M" first="M." last="M Urer">M. M Urer</name><affiliation><mods:affiliation>Department of Neurology, University Clinic Erlangen, Erlangen, Germany</mods:affiliation></affiliation></author><author><name sortKey="Cursiefen, S" sort="Cursiefen, S" uniqKey="Cursiefen S" first="S." last="Cursiefen">S. Cursiefen</name><affiliation><mods:affiliation>Department of Neurology, University Clinic Erlangen, Erlangen, Germany</mods:affiliation></affiliation></author><author><name sortKey="Kuckert, S" sort="Kuckert, S" uniqKey="Kuckert S" first="S." last="Kuckert">S. Kuckert</name><affiliation><mods:affiliation>Department of Neurology, Cologne City Hospitals, Cologne‐Merheim, Germany</mods:affiliation></affiliation></author><author><name sortKey="Klawe, C" sort="Klawe, C" uniqKey="Klawe C" first="C." last="Klawe">C. Klawe</name><affiliation><mods:affiliation>Department of Neurology, Barmherzige Brueder Hospital, Trier, Germany</mods:affiliation></affiliation></author><author><name sortKey="Maschke, M" sort="Maschke, M" uniqKey="Maschke M" first="M." last="Maschke">M. Maschke</name><affiliation><mods:affiliation>Department of Neurology, Barmherzige Brueder Hospital, Trier, Germany</mods:affiliation></affiliation></author><author><name sortKey="Tettenborn, B" sort="Tettenborn, B" uniqKey="Tettenborn B" first="B." last="Tettenborn">B. Tettenborn</name><affiliation><mods:affiliation>Department of Neurology, Cantonal Hospital St. Gallen, St Gallen, Switzerland</mods:affiliation></affiliation></author><author><name sortKey="Limmroth, V" sort="Limmroth, V" uniqKey="Limmroth V" first="V." last="Limmroth">V. Limmroth</name><affiliation><mods:affiliation>Department of Neurology, Cologne City Hospitals, Cologne‐Merheim, Germany</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">European Journal of Neurology</title><idno type="ISSN">1351-5101</idno><idno type="eISSN">1468-1331</idno><imprint><publisher>Blackwell Publishing Ltd</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="2010-01">2010-01</date><biblScope unit="volume">17</biblScope><biblScope unit="issue">1</biblScope><biblScope unit="page" from="31">31</biblScope><biblScope unit="page" to="37">37</biblScope></imprint><idno type="ISSN">1351-5101</idno></series><idno type="istex">D7EFE7528A83DCB4231262DC63949199D5BB7990</idno><idno type="DOI">10.1111/j.1468-1331.2009.02728.x</idno><idno type="ArticleID">ENE2728</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1351-5101</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>disease modifying therapy</term><term>multiple sclerosis</term><term>natalizumab</term><term>treatment failure</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract">Background: Natalizumab has been recommended for the treatment of relapsing–remitting multiple sclerosis (RRMS) in patients with insufficient response to interferon‐beta/glatiramer acetate (DMT) or aggressive MS. The pivotal trials were not conducted to investigate natalizumab monotherapy in this patient population.</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>N. Putzki</name><affiliations><json:string>Department of Neurology, University Clinic Essen, University of Duisburg‐Essen, Germany</json:string><json:string>Department of Neurology, Cantonal Hospital St. Gallen, St Gallen, Switzerland</json:string></affiliations></json:item><json:item><name>O. Yaldizli</name><affiliations><json:string>Department of Neurology, Cantonal Hospital St. Gallen, St Gallen, Switzerland</json:string></affiliations></json:item><json:item><name>M. Mäurer</name><affiliations><json:string>Department of Neurology, University Clinic Erlangen, Erlangen, Germany</json:string></affiliations></json:item><json:item><name>S. Cursiefen</name><affiliations><json:string>Department of Neurology, University Clinic Erlangen, Erlangen, Germany</json:string></affiliations></json:item><json:item><name>S. Kuckert</name><affiliations><json:string>Department of Neurology, Cologne City Hospitals, Cologne‐Merheim, Germany</json:string></affiliations></json:item><json:item><name>C. Klawe</name><affiliations><json:string>Department of Neurology, Barmherzige Brueder Hospital, Trier, Germany</json:string></affiliations></json:item><json:item><name>M. Maschke</name><affiliations><json:string>Department of Neurology, Barmherzige Brueder Hospital, Trier, Germany</json:string></affiliations></json:item><json:item><name>B. Tettenborn</name><affiliations><json:string>Department of Neurology, Cantonal Hospital St. Gallen, St Gallen, Switzerland</json:string></affiliations></json:item><json:item><name>V. Limmroth</name><affiliations><json:string>Department of Neurology, Cologne City Hospitals, Cologne‐Merheim, Germany</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>disease modifying therapy</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>multiple sclerosis</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>natalizumab</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>treatment failure</value></json:item></subject><articleId><json:string>ENE2728</json:string></articleId><language><json:string>eng</json:string></language><originalGenre><json:string>article</json:string></originalGenre><qualityIndicators><score>4.45</score><pdfVersion>1.3</pdfVersion><pdfPageSize>595.276 x 782.362 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natalizumab in multiple sclerosis patients previously treated with immunomodulating therapies</title></json:item></refBibs><genre><json:string>article</json:string></genre><host><volume>17</volume><publisherId><json:string>ENE</json:string></publisherId><pages><total>7</total><last>37</last><first>31</first></pages><issn><json:string>1351-5101</json:string></issn><issue>1</issue><genre><json:string>journal</json:string></genre><language><json:string>unknown</json:string></language><eissn><json:string>1468-1331</json:string></eissn><title>European Journal of Neurology</title><doi><json:string>10.1111/(ISSN)1468-1331</json:string></doi></host><categories><wos><json:string>science</json:string><json:string>neurosciences</json:string><json:string>clinical neurology</json:string></wos><scienceMetrix><json:string>health sciences</json:string><json:string>clinical medicine</json:string><json:string>neurology & 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in German speaking countries</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>Blackwell Publishing Ltd</publisher><pubPlace>Oxford, UK</pubPlace><availability><p>© 2009 The Author(s). Journal compilation © 2009 EFNS</p></availability><date>2010</date></publicationStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Efficacy of natalizumab in second line therapy of relapsing–remitting multiple sclerosis: results from a multi‐center study in German speaking countries</title><author xml:id="author-1"><persName><forename type="first">N.</forename><surname>Putzki</surname></persName><affiliation>Department of Neurology, University Clinic Essen, University of Duisburg‐Essen, Germany</affiliation><affiliation>Department of Neurology, Cantonal Hospital St. Gallen, St Gallen, Switzerland</affiliation></author><author xml:id="author-2"><persName><forename type="first">O.</forename><surname>Yaldizli</surname></persName><affiliation>Department of Neurology, Cantonal Hospital St. Gallen, St Gallen, Switzerland</affiliation></author><author xml:id="author-3"><persName><forename type="first">M.</forename><surname>Mäurer</surname></persName><affiliation>Department of Neurology, University Clinic Erlangen, Erlangen, Germany</affiliation></author><author xml:id="author-4"><persName><forename type="first">S.</forename><surname>Cursiefen</surname></persName><affiliation>Department of Neurology, University Clinic Erlangen, Erlangen, Germany</affiliation></author><author xml:id="author-5"><persName><forename type="first">S.</forename><surname>Kuckert</surname></persName><affiliation>Department of Neurology, Cologne City Hospitals, Cologne‐Merheim, Germany</affiliation></author><author xml:id="author-6"><persName><forename type="first">C.</forename><surname>Klawe</surname></persName><affiliation>Department of Neurology, Barmherzige Brueder Hospital, Trier, Germany</affiliation></author><author xml:id="author-7"><persName><forename type="first">M.</forename><surname>Maschke</surname></persName><affiliation>Department of Neurology, Barmherzige Brueder Hospital, Trier, Germany</affiliation></author><author xml:id="author-8"><persName><forename type="first">B.</forename><surname>Tettenborn</surname></persName><affiliation>Department of Neurology, Cantonal Hospital St. Gallen, St Gallen, Switzerland</affiliation></author><author xml:id="author-9"><persName><forename type="first">V.</forename><surname>Limmroth</surname></persName><affiliation>Department of Neurology, Cologne City Hospitals, Cologne‐Merheim, Germany</affiliation></author></analytic><monogr><title level="j">European Journal of Neurology</title><idno type="pISSN">1351-5101</idno><idno type="eISSN">1468-1331</idno><idno type="DOI">10.1111/(ISSN)1468-1331</idno><imprint><publisher>Blackwell Publishing Ltd</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="2010-01"></date><biblScope unit="volume">17</biblScope><biblScope unit="issue">1</biblScope><biblScope unit="page" from="31">31</biblScope><biblScope unit="page" to="37">37</biblScope></imprint></monogr><idno type="istex">D7EFE7528A83DCB4231262DC63949199D5BB7990</idno><idno type="DOI">10.1111/j.1468-1331.2009.02728.x</idno><idno type="ArticleID">ENE2728</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2010</date></creation><langUsage><language ident="en">en</language></langUsage><abstract><p>Background: Natalizumab has been recommended for the treatment of relapsing–remitting multiple sclerosis (RRMS) in patients with insufficient response to interferon‐beta/glatiramer acetate (DMT) or aggressive MS. The pivotal trials were not conducted to investigate natalizumab monotherapy in this patient population.</p></abstract><abstract><p>Method: Retrospective, multicenter study in Germany and Switzerland. Five major MS centers reported all RRMS patients who initiated natalizumab ≥12 months prior to study conduction.</p></abstract><abstract><p>Results: Ninety‐seven RRMS patients were included [69% female, mean age 36.5 years, mean Expanded Disability Status Scale (EDSS) 3.4; 93.8% were pre‐treated with DMT], mean treatment duration with natalizumab was 19.3 ± 6.1 months. We found a reduction of the annualized relapse rate from 2.3 to 0.2, 80.4% were relapse free with natalizumab. EDSS improved in 12.4% and 89.7% were progression free (change of >/= 1 EDSS point). Eighty‐six per cent of patients with highly active disease (>/= 2 relapses in the year and >/= 1 Gadolinium (Gd)+ lesion at study entry, n = 20) remained relapse free. The mean number of Gd enhancing lesions was reduced to 0.1 (0.8 at baseline). Discontinuation rate was 8.2% (4.1% for antibody‐positivity).</p></abstract><abstract><p>Conclusion: Natalizumab is effective after insufficient response to other DMT and also in patients with high disease activity.</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>keywords</head><item><term>disease modifying therapy</term></item><item><term>multiple sclerosis</term></item><item><term>natalizumab</term></item><item><term>treatment failure</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2010-01">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/document/D7EFE7528A83DCB4231262DC63949199D5BB7990/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Blackwell Publishing Ltd</publisherName><publisherLoc>Oxford, UK</publisherLoc></publisherInfo><doi origin="wiley" registered="yes">10.1111/(ISSN)1468-1331</doi><issn type="print">1351-5101</issn><issn type="electronic">1468-1331</issn><idGroup><id type="product" value="ENE"></id><id type="publisherDivision" value="ST"></id></idGroup><titleGroup><title type="main" sort="EUROPEAN JOURNAL OF NEUROLOGY">European Journal of Neurology</title></titleGroup></publicationMeta><publicationMeta level="part" position="01001"><doi origin="wiley">10.1111/ene.2009.17.issue-1</doi><numberingGroup><numbering type="journalVolume" number="17">17</numbering><numbering type="journalIssue" number="1">1</numbering></numberingGroup><coverDate startDate="2010-01">January 2010</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="7" status="forIssue"><doi origin="wiley">10.1111/j.1468-1331.2009.02728.x</doi><idGroup><id type="unit" value="ENE2728"></id></idGroup><countGroup><count type="pageTotal" number="7"></count></countGroup><titleGroup><title type="tocHeading1">Original Articles</title></titleGroup><copyright>© 2009 The Author(s). Journal compilation © 2009 EFNS</copyright><eventGroup><event type="firstOnline" date="2009-07-09"></event><event type="publishedOnlineFinalForm" date="2009-12-18"></event><event type="xmlConverted" agent="Converter:BPG_TO_WML3G version:2.3.2 mode:FullText source:FullText result:FullText" date="2010-03-06"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-01-24"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-10-16"></event></eventGroup><numberingGroup><numbering type="pageFirst" number="31">31</numbering><numbering type="pageLast" number="37">37</numbering></numberingGroup><correspondenceTo>Norman Putzki, Department of Neurology, University Clinic Essen, Hufelandstrasse 55, 45122 Essen, Germany (tel.: +49 201 7232363; fax: +49 201 7235901; e‐mail: <email normalForm="norman.putzki@uni-due.de">norman.putzki@uni‐due.de</email>).</correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:ENE.ENE2728.pdf"></link></linkGroup></publicationMeta><contentMeta><unparsedEditorialHistory>Received 16 April 2009 Accepted 25 May 2009</unparsedEditorialHistory><countGroup><count type="figureTotal" number="2"></count><count type="tableTotal" number="2"></count></countGroup><titleGroup><title type="main">Efficacy of natalizumab in second line therapy of relapsing–remitting multiple sclerosis: results from a multi‐center study in German speaking countries</title><title type="shortAuthors">N. Putzki <i>et al.</i></title><title type="short">Natalizumab in second line therapy paper statistics</title></titleGroup><creators><creator creatorRole="author" xml:id="cr1" affiliationRef="#a1 #a2"><personName><givenNames>N.</givenNames><familyName>Putzki</familyName></personName></creator><creator creatorRole="author" xml:id="cr2" affiliationRef="#a2"><personName><givenNames>O.</givenNames><familyName>Yaldizli</familyName></personName></creator><creator creatorRole="author" xml:id="cr3" affiliationRef="#a3"><personName><givenNames>M.</givenNames><familyName>Mäurer</familyName></personName></creator><creator creatorRole="author" xml:id="cr4" affiliationRef="#a3"><personName><givenNames>S.</givenNames><familyName>Cursiefen</familyName></personName></creator><creator creatorRole="author" xml:id="cr5" affiliationRef="#a4"><personName><givenNames>S.</givenNames><familyName>Kuckert</familyName></personName></creator><creator creatorRole="author" xml:id="cr6" affiliationRef="#a5"><personName><givenNames>C.</givenNames><familyName>Klawe</familyName></personName></creator><creator creatorRole="author" xml:id="cr7" affiliationRef="#a5"><personName><givenNames>M.</givenNames><familyName>Maschke</familyName></personName></creator><creator creatorRole="author" xml:id="cr8" affiliationRef="#a2"><personName><givenNames>B.</givenNames><familyName>Tettenborn</familyName></personName></creator><creator creatorRole="author" xml:id="cr9" affiliationRef="#a4"><personName><givenNames>V.</givenNames><familyName>Limmroth</familyName></personName></creator></creators><affiliationGroup><affiliation xml:id="a1" countryCode="DE"><unparsedAffiliation>Department of Neurology, University Clinic Essen, University of Duisburg‐Essen, Germany</unparsedAffiliation></affiliation><affiliation xml:id="a2" countryCode="CH"><unparsedAffiliation>Department of Neurology, Cantonal Hospital St. Gallen, St Gallen, Switzerland</unparsedAffiliation></affiliation><affiliation xml:id="a3" countryCode="DE"><unparsedAffiliation>Department of Neurology, University Clinic Erlangen, Erlangen, Germany</unparsedAffiliation></affiliation><affiliation xml:id="a4" countryCode="DE"><unparsedAffiliation>Department of Neurology, Cologne City Hospitals, Cologne‐Merheim, Germany</unparsedAffiliation></affiliation><affiliation xml:id="a5" countryCode="DE"><unparsedAffiliation>Department of Neurology, Barmherzige Brueder Hospital, Trier, Germany</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en"><keyword xml:id="k1">disease modifying therapy</keyword><keyword xml:id="k2">multiple sclerosis</keyword><keyword xml:id="k3">natalizumab</keyword><keyword xml:id="k4">treatment failure</keyword></keywordGroup><abstractGroup><abstract type="main" xml:lang="en"><p><b>Background: </b> Natalizumab has been recommended for the treatment of relapsing–remitting multiple sclerosis (RRMS) in patients with insufficient response to interferon‐beta/glatiramer acetate (DMT) or aggressive MS. The pivotal trials were not conducted to investigate natalizumab monotherapy in this patient population.</p><p><b>Method: </b> Retrospective, multicenter study in Germany and Switzerland. Five major MS centers reported all RRMS patients who initiated natalizumab ≥12 months prior to study conduction.</p><p><b>Results: </b> Ninety‐seven RRMS patients were included [69% female, mean age 36.5 years, mean Expanded Disability Status Scale (EDSS) 3.4; 93.8% were pre‐treated with DMT], mean treatment duration with natalizumab was 19.3 ± 6.1 months. We found a reduction of the annualized relapse rate from 2.3 to 0.2, 80.4% were relapse free with natalizumab. EDSS improved in 12.4% and 89.7% were progression free (change of >/= 1 EDSS point). Eighty‐six per cent of patients with highly active disease (>/= 2 relapses in the year and >/= 1 Gadolinium (Gd)+ lesion at study entry, <i>n</i> = 20) remained relapse free. The mean number of Gd enhancing lesions was reduced to 0.1 (0.8 at baseline). Discontinuation rate was 8.2% (4.1% for antibody‐positivity).</p><p><b>Conclusion: </b> Natalizumab is effective after insufficient response to other DMT and also in patients with high disease activity.</p></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Efficacy of natalizumab in second line therapy of relapsing–remitting multiple sclerosis: results from a multi‐center study in German speaking countries</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Natalizumab in second line therapy paper statistics</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Efficacy of natalizumab in second line therapy of relapsing–remitting multiple sclerosis: results from a multi‐center study in German speaking countries</title></titleInfo><name type="personal"><namePart type="given">N.</namePart><namePart type="family">Putzki</namePart><affiliation>Department of Neurology, University Clinic Essen, University of Duisburg‐Essen, Germany</affiliation><affiliation>Department of Neurology, Cantonal Hospital St. Gallen, St Gallen, Switzerland</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">O.</namePart><namePart type="family">Yaldizli</namePart><affiliation>Department of Neurology, Cantonal Hospital St. Gallen, St Gallen, Switzerland</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">M.</namePart><namePart type="family">Mäurer</namePart><affiliation>Department of Neurology, University Clinic Erlangen, Erlangen, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">S.</namePart><namePart type="family">Cursiefen</namePart><affiliation>Department of Neurology, University Clinic Erlangen, Erlangen, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">S.</namePart><namePart type="family">Kuckert</namePart><affiliation>Department of Neurology, Cologne City Hospitals, Cologne‐Merheim, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">C.</namePart><namePart type="family">Klawe</namePart><affiliation>Department of Neurology, Barmherzige Brueder Hospital, Trier, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">M.</namePart><namePart type="family">Maschke</namePart><affiliation>Department of Neurology, Barmherzige Brueder Hospital, Trier, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">B.</namePart><namePart type="family">Tettenborn</namePart><affiliation>Department of Neurology, Cantonal Hospital St. Gallen, St Gallen, Switzerland</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">V.</namePart><namePart type="family">Limmroth</namePart><affiliation>Department of Neurology, Cologne City Hospitals, Cologne‐Merheim, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>Blackwell Publishing Ltd</publisher><place><placeTerm type="text">Oxford, UK</placeTerm></place><dateIssued encoding="w3cdtf">2010-01</dateIssued><edition>Received 16 April 2009 Accepted 25 May 2009</edition><copyrightDate encoding="w3cdtf">2010</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">2</extent><extent unit="tables">2</extent></physicalDescription><abstract>Background: Natalizumab has been recommended for the treatment of relapsing–remitting multiple sclerosis (RRMS) in patients with insufficient response to interferon‐beta/glatiramer acetate (DMT) or aggressive MS. The pivotal trials were not conducted to investigate natalizumab monotherapy in this patient population.</abstract><abstract>Method: Retrospective, multicenter study in Germany and Switzerland. Five major MS centers reported all RRMS patients who initiated natalizumab ≥12 months prior to study conduction.</abstract><abstract>Results: Ninety‐seven RRMS patients were included [69% female, mean age 36.5 years, mean Expanded Disability Status Scale (EDSS) 3.4; 93.8% were pre‐treated with DMT], mean treatment duration with natalizumab was 19.3 ± 6.1 months. We found a reduction of the annualized relapse rate from 2.3 to 0.2, 80.4% were relapse free with natalizumab. EDSS improved in 12.4% and 89.7% were progression free (change of >/= 1 EDSS point). Eighty‐six per cent of patients with highly active disease (>/= 2 relapses in the year and >/= 1 Gadolinium (Gd)+ lesion at study entry, n = 20) remained relapse free. The mean number of Gd enhancing lesions was reduced to 0.1 (0.8 at baseline). Discontinuation rate was 8.2% (4.1% for antibody‐positivity).</abstract><abstract>Conclusion: Natalizumab is effective after insufficient response to other DMT and also in patients with high disease activity.</abstract><subject lang="en"><genre>keywords</genre><topic>disease modifying therapy</topic><topic>multiple sclerosis</topic><topic>natalizumab</topic><topic>treatment failure</topic></subject><relatedItem type="host"><titleInfo><title>European Journal of Neurology</title></titleInfo><genre type="journal">journal</genre><identifier type="ISSN">1351-5101</identifier><identifier type="eISSN">1468-1331</identifier><identifier type="DOI">10.1111/(ISSN)1468-1331</identifier><identifier type="PublisherID">ENE</identifier><part><date>2010</date><detail type="volume"><caption>vol.</caption><number>17</number></detail><detail type="issue"><caption>no.</caption><number>1</number></detail><extent unit="pages"><start>31</start><end>37</end><total>7</total></extent></part></relatedItem><identifier type="istex">D7EFE7528A83DCB4231262DC63949199D5BB7990</identifier><identifier type="DOI">10.1111/j.1468-1331.2009.02728.x</identifier><identifier type="ArticleID">ENE2728</identifier><accessCondition type="use and reproduction" contentType="copyright">© 2009 The Author(s). 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