{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T17:39:49Z","timestamp":1787247589818,"version":"build-2736575974"},"reference-count":15,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,12,16]],"date-time":"2024-12-16T00:00:00Z","timestamp":1734307200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate the impact of transition interval length when switching from natalizumab (NTZ) to anti\u2010CD20 monoclonal antibodies (antiCD20) on recurrent disease activity and safety in relapsing multiple sclerosis (RMS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Aggregating data from 8 MS centres in Austria, Switzerland, and Germany, we included RMS patients who (i) continuously received NTZ for \u22653\u2009months, (ii) were switched to antiCD20, and (iii) had \u226512\u2009months follow\u2010up after switch. The primary endpoint was occurrence of relapse after switch, secondary endpoints included severe infections (CTCAE grade \u22653).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, 139 RMS patients were included (70.5% females, mean age at switch 38.8\u2009years [SD 9.7], mean disease duration at switch 11.3\u2009years [SD 6.2], median duration on NTZ 4.4\u2009years [range: 0.3\u201316.4], median transition interval 58\u2009days [0\u2013180]). Relapse occurred in 18 patients (12.9%) after NTZ discontinuation. Of those, 11 (61.1%) patients relapsed during the transition interval. No patient with a transition interval below 30\u2009days experienced a relapse, compared to 11.1% and 16.1% with transition intervals of 30\u201344\u2009days and\u2009\u2265\u200945\u2009days, respectively. In multivariable Cox regression, a transition interval\u2009\u2265\u200945\u2009days predicted a 4.73\u2010fold increased risk of relapse. Over approximately 4\u2009years of follow\u2010up, six severe infections were reported without any noticeable effect of transition interval length. No PML occurred.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Switching from NTZ to antiCD20 is generally both effective and safe. Keeping the transition interval below 30\u2009days provides the optimal balance between preventing recurrent disease activity and ensuring safety.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.16587","type":"journal-article","created":{"date-parts":[[2024,12,17]],"date-time":"2024-12-17T06:40:28Z","timestamp":1734417628000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Switching from natalizumab to <scp>antiCD20<\/scp> monoclonal antibodies: Short transition interval is associated with improved outcome"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0825-0851","authenticated-orcid":false,"given":"Gabriel","family":"Bsteh","sequence":"first","affiliation":[{"name":"Department of Neurology Medical University of Vienna  Wien Austria"},{"name":"Comprehensive Center for Clinical Neurosciences and Mental Health Medical University of Vienna  Wien 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