{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T11:39:23Z","timestamp":1791545963893,"version":"4.3.4"},"reference-count":32,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2024,7,1]],"date-time":"2024-07-01T00:00:00Z","timestamp":1719792000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100005614","name":"Biogen","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005614","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Mult Scler"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>One strategy to mitigate progressive multifocal leukoencephalopathy (PML) risk is to switch to other highly effective disease-modifying therapies (DMTs). However, the optimal switch DMT following natalizumab (NTZ) discontinuation is yet to be determined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>The objective of the study is to determine the most effective and tolerable DMTs to switch to following NTZ discontinuation due to John Cunningham virus (JCV) antibody positivity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This is a multicenter observational cohort study that included all stable relapsing-remitting multiple sclerosis (MS) patients who were treated with NTZ for at least 6 months before switching therapy due to JCV antibody positivity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Of 321 patients, 255 switched from NTZ to rituximab\/ocrelizumab, 52 to fingolimod, and 14 to alemtuzumab, with higher annualized relapse rate (ARR) in fingolimod switchers (0.193) compared with rituximab\/ocrelizumab or alemtuzumab (0.028 and 0.032, respectively). Fingolimod switchers also had increased disability progression ( p = 0.014) and a higher proportion developed magnetic resonance imaging (MRI) lesions compared with rituximab\/ocrelizumab (62.9% vs. 13.0%, p &lt; 0.001, and 66.6% vs. 24.0%, p &lt; 0.001, respectively). Mean drug survival favored rituximab\/ocrelizumab or alemtuzumab over fingolimod ( p &lt; 0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Our study shows superior effectiveness of rituximab\/ocrelizumab and alemtuzumab compared with fingolimod in stable patients switching from NTZ due to JC virus antibody positivity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13524585241261565","type":"journal-article","created":{"date-parts":[[2024,7,26]],"date-time":"2024-07-26T03:09:33Z","timestamp":1721963373000},"page":"1026-1035","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Safety and effectiveness of disease-modifying therapies after switching from natalizumab"],"prefix":"10.1177","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6842-5609","authenticated-orcid":false,"given":"Maya","family":"Zeineddine","sequence":"first","affiliation":[{"name":"Inserm U1094, IRD U270, Univ. Limoges, CHU Limoges, EpiMaCT\u2014Epidemiology of chronic diseases in tropical zone, Institute of Epidemiology and Tropical Neurology, Omega Health, Limoges, France"},{"name":"School of Pharmacy, Lebanese American University, Byblos, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raed","family":"Al-Roughani","sequence":"additional","affiliation":[{"name":"Al-Amiri Hospital, Kuwait City, Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samar","family":"Farouk Ahmed","sequence":"additional","affiliation":[{"name":"Ibn Sina Hospital, Kuwait City, Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samia","family":"Khoury","sequence":"additional","affiliation":[{"name":"American University of Beirut Medical Center, Nehme and Therese Tohme Multiple Sclerosis Center, Beirut, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nabil","family":"El-Ayoubi","sequence":"additional","affiliation":[{"name":"American University of Beirut Medical Center, Nehme and Therese Tohme Multiple Sclerosis Center, Beirut, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akram","family":"Al-Mahdawi","sequence":"additional","affiliation":[{"name":"Baghdad Medical City Teaching Hospital, Baghdad, Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaber","family":"Al-Khabouri","sequence":"additional","affiliation":[{"name":"Department of Neurology, The Royal Hospital, Muscat, Oman"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullah","family":"Al-Asmi","sequence":"additional","affiliation":[{"name":"Neurology Unit, Department of Medicine, College of Medicine and Health Sciences and Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amina","family":"Chentouf","sequence":"additional","affiliation":[{"name":"Neurology Department, University Hospital Center, Oran, Algeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5892-751X","authenticated-orcid":false,"given":"Jihad","family":"Inshasi","sequence":"additional","affiliation":[{"name":"MS Department, Rashid Hospital and Dubai Medical College, Dubai Health Authority, Dubai, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9615-3797","authenticated-orcid":false,"given":"Riadh","family":"Gouider","sequence":"additional","affiliation":[{"name":"Department of Neurology, LR18SP03, Clinical Investigation Center \u201cNeurosciences and Mental Health,\u201d Razi University Hospital\u2014Manouba, Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saloua","family":"Mrabet","sequence":"additional","affiliation":[{"name":"Department of Neurology, LR18SP03, Clinical Investigation Center \u201cNeurosciences and Mental Health,\u201d Razi University Hospital\u2014Manouba, Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nevin","family":"Shalaby","sequence":"additional","affiliation":[{"name":"Neurology Department, Kasr Alainy School of Medicine, Cairo University, Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joelle","family":"Massouh","sequence":"additional","affiliation":[{"name":"Neurology Institute and MS Center, Harley Street Medical Center, Abu Dhabi, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farah","family":"Mohamed Ramzy Hasan Mohamed","sequence":"additional","affiliation":[{"name":"Neurology Institute and MS Center, Harley Street Medical Center, Abu Dhabi, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amal","family":"Al-Hajje","sequence":"additional","affiliation":[{"name":"Faculty of Pharmacy, Lebanese University, Beirut, Lebanon"},{"name":"National Institute of Public Health, Clinical Epidemiology and Toxicology (INSPECT-LB), Beirut, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pascale","family":"Salameh","sequence":"additional","affiliation":[{"name":"Faculty of Pharmacy, Lebanese University, Beirut, Lebanon"},{"name":"National Institute of Public Health, Clinical Epidemiology and Toxicology (INSPECT-LB), Beirut, Lebanon"},{"name":"School of Medicine, Lebanese American University, Byblos, Lebanon; Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hani","family":"Dimassi","sequence":"additional","affiliation":[{"name":"Faculty of Pharmacy, Lebanese University, Beirut, Lebanon"},{"name":"National Institute of Public Health, Clinical Epidemiology and Toxicology (INSPECT-LB), Beirut, Lebanon"},{"name":"School of Medicine, Lebanese American University, Byblos, Lebanon; Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farid","family":"Boumediene","sequence":"additional","affiliation":[{"name":"Inserm U1094, IRD U270, Univ. 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