ACTRIMS- ECTRIMS MSBoston 2. Poster Sessions 2. Risk of relapse after natalizumab discontinuation: which is the best treatment option? P Iaffaldano. 1, V Lepore. 20,000,000 Visitors and counting - fix my hit counter and earn credit$, LOL: We salute our Nation’s military, past and present. IN WONDERFUL ALBANY, NY, USA. Android Software Links: For the Android Mobile Telephone/Tablet Operating System by Google. Content by Respective Authors. The following are lists of notable people who intentionally killed themselves. Suicides committed under duress are included. Deaths by accident or misadventure are. G Lucisano. 2, C Pozzilli. V Brescia Morra. 4, A Ghezzi. E Millefiorini. 6, F Patti. A Lugaresi. 8, GB Zimatore. MG Marrosu. 10, MP Amato. A Bertolotto. 12, R Bergamaschi. F Granella. 14, G Coniglio. Download and listen to new, exclusive, electronic dance music and house tracks. Available on mp3 and wav at the world’s largest store for DJs. G Tedeschi. 16, D Paolicelli. C Tortorella. 1, P Sola. G Lus. 16, MT Ferrò1. G Iuliano. 19, F Corea. A Protti. 21, P Cavalla. E Montanari. 23, G Comi. M Trojano. 11. University of Bari Aldo Moro, Department of Basic Medical Sciences, Neurosciences and Sense Organs, Bari, Italy, 2. Fondazione Mario Negri Sud, Department of Clinical Pharmacology and Epidemiology, Santa Maria Imbaro, Italy, 3. University of Rome Sapienza, Department of Neurology and Psychiatry, Roma, Italy, 4. University Federico II, Department of Neurological Sciences, Napoli, Italy, 5. Azienda Ospedaliera S. Antonio Abate, Gallarate, Italy, 6. University of Rome Sapienza, Roma, Italy, 7. University of Catania, Catania, Italy, 8. University of Chieti, Chieti, Italy, 9. Ospedale Dimiccoli, Barletta, Italy, 1. University of Cagliari, Cagliari, Italy, 1. University of Florence, Firenze, Italy, 1. Ospedale San Luigi Gonzaga, Orbassano, Italy, 1. Fondazione Mondino, Pavia, Italy, 1. University of Parma, Parma, Italy, 1. Ospedale Madonna delle Grazie, Matera, Italy, 1. University of Naples II, Napoli, Italy, 1. Nuovo Ospedale S. Agostino, Estense, Modena, Italy, 1. Ospedale Maggiore di Crema, Crema, Italy, 1. Azienda Ospedaliera San Giovanni Di Dio, Salerno, Italy, 2. Ospedale San Giovanni Battista, Foligno, Italy, 2. Ospedale Niguarda Ca Granda, Milano, Italy, 2. University of Torino, Torino, Italy, 2. Ospedale Civile di Fidenza, Fidenza, Italy, 2. Fondazione San Raffaele del Monte Tabor, Milano, Italy. Background: To date, no direct comparisons among disease modifying drugs (DMDs) have been performed to evaluate the best treatment option for reducing the relapse risk occurring after natalizumab (NTZ) discontinuation in Multiple Sclerosis (MS) patients. Objectives: To evaluate predictors of risk of relapses after NTZ stop and to compare the effect of different treatment regimens in reducing this risk. Methods: An unselected cohort of 6. MS patients who discontinued NTZ therapy were extracted from the Italian i. Med. Web registry. The relapse risk was estimated through a Poisson regression model adjusted for the following covariates: sex, age, first drug after NTZ, reason for discontinuation, comorbidity, previous DMDs/immunosuppressant (IS) exposure, disease duration, EDSS, number of infusions, relapses (yes/no) during NTZ and in the year before NTZ. Patients who started, after NTZ, a treatment with fingolimod (FIN) or with other DMDs were propensity score (PS)- matched on a 1- to- 1 basis at the switching date, and the relapse risk was estimated by a Poisson model. Results: At least one clinical relapse after stopping NTZ was experienced by 2. During the follow- up (1. DMDs prescription after a mean wash- out time of 4. The Poisson regression analysis demonstrated that a higher number of relapses in the year before and during NTZ treatment was correlated to the risk of relapses (IRR=1. IRR=1. 3. 9, p=0. NTZ discontinuation. During the follow- up, patients not treated at all resulted at higher relapse risk in comparison to patients receiving FIN (IRR=4. DMDs (IRR=2. 4. 3, p< 0. A significant lower risk of relapses was found in patients treated with FIN in comparison to those treated with other DMDs (IRR=0. Poisson model performed in 8. FIN and 8. 8 PS- matched patients receiving other DMDs (IRR=0. Conclusions: Our results confirm the risk of clinical disease reactivation after NTZ suspension, and indicate that an alternative treatment should be prompt resumed mainly in patients with a previous very active course. Moreover, our results demonstrate a superiority of FIN in comparison to other DMDs in preventing relapses after NTZ discontinuation.
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November 2017
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