{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T18:27:26Z","timestamp":1778005646685,"version":"3.51.4"},"reference-count":38,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2016,3,21]],"date-time":"2016-03-21T00:00:00Z","timestamp":1458518400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006314","name":"Biogen Idec","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006314","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2016,6]]},"abstract":"<jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>The long\u2010term benefit of natalizumab on brain atrophy progression in multiple sclerosis (<jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content>) patients is unknown. Our aim was to investigate its effect over 5 years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This prospective study included 60 relapsing <jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content> patients who started natalizumab treatment in years 2006\u22122007.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At the 5\u2010year follow\u2010up, 20 patients discontinued natalizumab after an average of 29.5 cycles, 27 continued natalizumab treatment with some periods of honeymoon (average of 38.4 infusions) and 13 never stopped natalizumab (average of 60.6 infusions). In multiple linear regression analysis, adjusted for age, sex and baseline magnetic resonance imaging (MRI) status, the number of natalizumab infusions was associated with decrease of relapse rate (adjusted <jats:italic>P<\/jats:italic> = 0.037), but no association was found with the progression of disability, accumulation of lesion burden or brain volume loss. However, only one (8%) patient in the continuous monthly group experienced disability progression compared to 10 (37%) in the non\u2010continuous and seven (35%) in the discontinuation natalizumab groups. At the follow\u2010up, two patients had died [one from a fatal case of progressive multifocal leukoencephalopathy (<jats:styled-content style=\"fixed-case\">PML<\/jats:styled-content>) and one from a car accident] and 15 patients were lost to follow\u2010up. There was another case of non\u2010fatal <jats:styled-content style=\"fixed-case\">PML<\/jats:styled-content> over the follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In line with previous reports, <jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content> patients with longer and continuous use of natalizumab had fewer relapses and remained stable in their disability status. No difference in lesion burden accumulation or brain atrophy development was found in relation to the duration of natalizumab use. <jats:styled-content style=\"fixed-case\">PML<\/jats:styled-content> occurred in 2.5% of patients in this small sample cohort. Given the increased risk of <jats:styled-content style=\"fixed-case\">PML<\/jats:styled-content> and uncertain benefit of prolonged natalizumab use on clinical and <jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content> outcomes of disease progression found in this study, a careful risk\u2212benefit therapeutic assessment is mandatory.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.12992","type":"journal-article","created":{"date-parts":[[2016,3,22]],"date-time":"2016-03-22T02:00:44Z","timestamp":1458612044000},"page":"1101-1109","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Effect of natalizumab on brain atrophy and disability progression in multiple sclerosis patients over 5 years"],"prefix":"10.1111","volume":"23","author":[{"given":"R.","family":"Zivadinov","sequence":"first","affiliation":[{"name":"Department of Neurology Buffalo Neuroimaging Analysis Center University at Buffalo State University of New York Buffalo NY USA"},{"name":"MR Imaging Clinical Translational Research Center School of Medicine and Biomedical Sciences University at Buffalo State University of New York Buffalo NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.","family":"Hojnacki","sequence":"additional","affiliation":[{"name":"Jacobs MS Center Department of Neurology University at Buffalo State University of New York Buffalo NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N.","family":"Bergsland","sequence":"additional","affiliation":[{"name":"Department of Neurology Buffalo Neuroimaging Analysis Center University at Buffalo State University of New York Buffalo NY USA"},{"name":"Magnetic Resonance Laboratory IRCCS Don Gnocchi Foundation Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Kennedy","sequence":"additional","affiliation":[{"name":"Department of Neurology Buffalo Neuroimaging Analysis Center University at Buffalo State University of New York Buffalo NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Hagemeier","sequence":"additional","affiliation":[{"name":"Department of Neurology Buffalo Neuroimaging Analysis Center University at Buffalo State University of New York Buffalo NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Melia","sequence":"additional","affiliation":[{"name":"Department of Neurology Buffalo Neuroimaging Analysis Center University at Buffalo State University of New York Buffalo NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D. 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