{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T13:42:03Z","timestamp":1753882923561,"version":"3.41.2"},"reference-count":39,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2021,10,1]],"date-time":"2021-10-01T00:00:00Z","timestamp":1633046400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100013995","name":"Sanofi Genzyme","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100013995","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Multiple Sclerosis Journal - Experimental, Translational and Clinical"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p> Natalizumab (NTZ) is a highly effective disease modifying treatment for relapsing multiple sclerosis (RMS), but it increases risk of progressive multifocal leukoencephalopathy (PML) in patients with serum anti- John Cunningham virus (JCV) antibodies. <\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p> To assess the safety and efficacy of rapid transition, from NTZ to teriflunomide (TFM) in RMS patients. <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p> Clinically stable NTZ-treated, anti-JCV antibody positive RMS patients were switched to TFM 28\u2009\u00b1\u20097 days after their last dose of NTZ. The primary endpoint was proportion of relapse free patients at 24 months. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> Median [IQR] age of the 55 enrolled patients was 47 [40.7, 56.3] years, 76% were female. The median [IQR] number of prior NTZ treatments was 34 [18, 64]. annualized relapse rate (ARR) was 0.07 and 77% of the patients were relapse free at 24 months. Mean time to first GAD\u2009+\u2009lesion was 19.6 months, and to new\/enlarging T2 lesion was 19.2 months. Mean time to 3 month sustained disability worsening (SDW) was 22 months and proportion free of 3-month SDW was 0.87. There were no cases of PML. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p> The washout-free transition of NTZ to TFM was an efficacious and safe strategy for patients at risk of developing PML. ClinicalTrials.gov Identifier: NCT01970410 <\/jats:p><\/jats:sec>","DOI":"10.1177\/20552173211066588","type":"journal-article","created":{"date-parts":[[2021,12,16]],"date-time":"2021-12-16T11:39:15Z","timestamp":1639654755000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["The results of a 24-month controlled, prospective study of relapsing multiple sclerosis patients at risk for progressive multifocal encephalopathy, who switched from prolonged use of natalizumab to teriflunomide"],"prefix":"10.1177","volume":"7","author":[{"given":"Stanley","family":"Cohan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tiffany","family":"Gervasi-Follmar","sequence":"additional","affiliation":[{"name":"Providence Multiple Sclerosis Center, Providence Health & Services, Portland, OR, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aneesh","family":"Kamath","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vineetha","family":"Kamath","sequence":"additional","affiliation":[{"name":"The MS Center of Northeastern New York, Latham, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6636-5203","authenticated-orcid":false,"given":"Chiayi","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyle","family":"Smoot","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Baraban","sequence":"additional","affiliation":[{"name":"Providence Multiple Sclerosis Center, Providence Health & Services Portland, OR, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keith","family":"Edwards","sequence":"additional","affiliation":[{"name":"The MS Center of Northeastern New York, Latham, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,12,16]]},"reference":[{"key":"bibr1-20552173211066588","doi-asserted-by":"publisher","DOI":"10.1002\/glia.22597"},{"key":"bibr2-20552173211066588","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2015.00636"},{"key":"bibr3-20552173211066588","doi-asserted-by":"publisher","DOI":"10.1038\/nn.2923"},{"key":"bibr4-20552173211066588","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa044397"},{"key":"bibr5-20552173211066588","doi-asserted-by":"publisher","DOI":"10.1038\/356063a0"},{"key":"bibr6-20552173211066588","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1107829"},{"key":"bibr7-20552173211066588","unstructured":"Tysabri (natalizumab) injection, for intravenious use [package insert]. 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