{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T13:08:35Z","timestamp":1767704915722},"reference-count":27,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2014,5,19]],"date-time":"2014-05-19T00:00:00Z","timestamp":1400457600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CNS Neurosci Ther"],"published-print":{"date-parts":[[2014,8]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Natalizumab (<jats:styled-content style=\"fixed-case\">NTZ<\/jats:styled-content>) discontinuation leads to multiple sclerosis (<jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content>) recurrence, but represents the only known strategy to limit the risk of progressive multifocal leukoencephalopathy (<jats:styled-content style=\"fixed-case\">PML<\/jats:styled-content>) in <jats:styled-content style=\"fixed-case\">JCV<\/jats:styled-content> seropositive patients. Here, we compared the clinical and imaging features of three groups of patients who discontinued <jats:styled-content style=\"fixed-case\">NTZ<\/jats:styled-content> treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We treated 25 patients with subcutaneous <jats:styled-content style=\"fixed-case\">INF<\/jats:styled-content>\u03b2\u20101b (<jats:styled-content style=\"fixed-case\">INF<\/jats:styled-content> group), 40 patients with glatiramer acetate (GA group), and 40 patients with GA plus pulse steroid (<jats:styled-content style=\"fixed-case\">GA<\/jats:styled-content>+<jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content> group).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Six of 25 patients (24%) of the <jats:styled-content style=\"fixed-case\">INF<\/jats:styled-content> group were relapse\u2010free 6\u00a0months after <jats:styled-content style=\"fixed-case\">NTZ<\/jats:styled-content> suspension. In GA group, a significant higher proportion of patients (26 of 40 patients, 65%) were relapse\u2010free (<jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.05). Far from improving the clinical effects of GA in post\u2010<jats:styled-content style=\"fixed-case\">NTZ<\/jats:styled-content> setting, combination of <jats:styled-content style=\"fixed-case\">GA<\/jats:styled-content>+<jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content> was associated with lower relapse\u2010free rate than GA alone (40% vs. 65%, <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.04). Also on MRI parameters, combination of <jats:styled-content style=\"fixed-case\">GA<\/jats:styled-content>+<jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content> was associated with worse outcome than <jats:styled-content style=\"fixed-case\">GA<\/jats:styled-content> alone, as 22 of 26 subjects (84.6%) had <jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content> evidence of disease activity 6\u00a0months after <jats:styled-content style=\"fixed-case\">NTZ<\/jats:styled-content> discontinuation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Corticosteroids should not be used in combination with <jats:styled-content style=\"fixed-case\">GA<\/jats:styled-content> to prevent post\u2010<jats:styled-content style=\"fixed-case\">NTZ<\/jats:styled-content> disease recurrence.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cns.12282","type":"journal-article","created":{"date-parts":[[2014,5,19]],"date-time":"2014-05-19T06:04:51Z","timestamp":1400479491000},"page":"748-753","source":"Crossref","is-referenced-by-count":9,"title":["Treatment Options to Reduce Disease Activity After Natalizumab: Paradoxical Effects of Corticosteroids"],"prefix":"10.1111","volume":"20","author":[{"given":"Silvia","family":"Rossi","sequence":"first","affiliation":[{"name":"Clinica Neurologica Dipartimento di Medicina dei Sistemi Universit\u00e0 Tor Vergata, &amp; 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