{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T10:57:28Z","timestamp":1791197848211,"version":"4.1.0"},"reference-count":42,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T00:00:00Z","timestamp":1774569600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T00:00:00Z","timestamp":1774569600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100008021","name":"Bristol-Myers Squibb Canada","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008021","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ann Clin Transl Neurol"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Return of disease activity is expected when patients discontinue disease\u2010modifying therapy (DMT) for multiple sclerosis (MS). Some MS DMTs are associated with higher\u2010than\u2010expected disease activity (rebound) after discontinuation. This exploratory analysis assessed disease activity and risk of rebound after ozanimod discontinuation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>DAYBREAK (NCT02576717; October 2015\u2013April 2023) was a single\u2010arm, open\u2010label extension trial of ozanimod 0.92\u2009mg\/d in participants with relapsing MS who completed phase 1\u20133 ozanimod trials. Two protocol amendments increased the required safety follow\u2010up from an initial 28\u2009days to 75 and then 90\u2009days. Confirmed post\u2010treatment relapses were characterized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 2494 participants, 1679 participants had \u2265\u20091\u2009day of follow\u2010up and did not initiate commercial ozanimod in \u2264\u200914\u2009days of exiting the trial; 30.6% had \u2264\u200960\u2009days of post\u2010treatment follow\u2010up. Fifty\u2010five participants (3.3%) had known post\u2010treatment relapse. Fifty\u2010four were not taking an MS DMT when they relapsed; one relapsed soon after starting fingolimod. Relapses were associated with Expanded Disability Status Scale (EDSS) score increases of 0\u20133 points (median 1 point); the participant with the 3\u2010point increase had a moderate relapse and complete recovery in 23\u2009days. Forty\u2010two participants (76.4%) fully recovered, 11 (20.0%) partially recovered, and 2 (3.6%) did not recover. Only one (1.8%) relapse was considered severe by the investigator: EDSS increased from 7.5 to 8.0, and the participant partially recovered within 36\u2009days.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>Most participants did not relapse within 90\u2009days following ozanimod discontinuation. Post\u2010treatment relapse cases suggestive of a rebound effect were not observed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acn3.70366","type":"journal-article","created":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T08:29:34Z","timestamp":1774600174000},"page":"2017-2026","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Multiple Sclerosis Relapse Activity After Ozanimod Discontinuation in\n                    <scp>DAYBREAK<\/scp>\n                    Trial Participants"],"prefix":"10.1002","volume":"13","author":[{"given":"Ralf","family":"Gold","sequence":"first","affiliation":[{"name":"Neurologische Universit\u00e4tsklinik St. Josef Hospital  Bochum Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1213-7218","authenticated-orcid":false,"given":"Krzysztof W.","family":"Selmaj","sequence":"additional","affiliation":[{"name":"Center of Neurology  Lodz Poland"},{"name":"Department of Neurology University of Warmia &amp; Mazury  Olsztyn Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Regina","family":"Berkovich","sequence":"additional","affiliation":[{"name":"Medical Imaging Center of Southern California  Santa Monica California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey A.","family":"Cohen","sequence":"additional","affiliation":[{"name":"Mellen Center for Multiple Sclerosis Treatment and Research Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giancarlo","family":"Comi","sequence":"additional","affiliation":[{"name":"Vita\u2010Salute San Raffaele University and Casa di Cura Igea  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva K.","family":"Havrdov\u00e1","sequence":"additional","affiliation":[{"name":"Department of Neurology and Center for Clinical Neuroscience First Medical Faculty and General University Hospital, Charles University  Prague Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James K.","family":"Sheffield","sequence":"additional","affiliation":[{"name":"Bristol Myers Squibb  Princeton New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hetal","family":"Desai","sequence":"additional","affiliation":[{"name":"Bristol Myers Squibb  Princeton New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun\u2010Yen","family":"Cheng","sequence":"additional","affiliation":[{"name":"Bristol Myers Squibb  Princeton New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon V.","family":"Riolo","sequence":"additional","affiliation":[{"name":"Bristol Myers Squibb  Princeton New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Thorpe","sequence":"additional","affiliation":[{"name":"Bristol Myers Squibb  Princeton New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"DeBoer","sequence":"additional","affiliation":[{"name":"Bristol Myers Squibb  Princeton New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7689-2533","authenticated-orcid":false,"given":"Bruce A. 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