Multiple Sclerosis Symptom Recrudescence at the End of the Natalizumab Dosing Cycle
- 1 July 2014
- journal article
- Published by Consortium of Multiple Sclerosis Centers in International Journal of MS Care
- Vol. 16 (2), 92-98
- https://doi.org/10.7224/1537-2073.2013-017
Abstract
Background: This study was undertaken to determine how frequently patients receiving natalizumab for multiple sclerosis (MS) experience recrudescence of their MS symptoms at the end of the dosing cycle. Methods: One hundred consecutive MS patients receiving natalizumab completed a survey evaluating changes in symptoms during the natalizumab dosing cycle. Ninety-one patients also completed questionnaires at two time points: the first week after natalizumab infusion and the last week of the dosing cycle. These included the Multiple Sclerosis Quality of Life–54 (MSQOL-54), Fatigue Visual Analog Scale (VAS), Fatigue Severity Scale (FSS), and Beck Depression Inventory–II (BDI-II). Results: End of dosing interval (EDI) symptoms were reported as currently being experienced by 57% of respondents. An additional 10% reported that they previously experienced that phenomenon, but not currently, and 33% reported never experiencing this. In those with EDI symptoms, they began to occur a median of 21 days after infusion and improved again a median of 1 day after infusion. The most common symptoms reported were fatigue, weakness, walking impairment, and cognitive difficulties. No specific demographic or disease characteristics were associated with this phenomenon. In the subgroup with EDI symptoms, the MSQOL-54, Fatigue VAS, FSS, and BDI-II scores were all significantly worse in the last week of the dosing cycle when compared with the first week. No difference was seen in these scores between first and last week in the subgroup not experiencing symptom recrudescence. Conclusions: Recrudescence of fatigue, weakness, walking impairment, or cognitive difficulties at the end of the dosing cycle occurs in about two-thirds of MS patients receiving natalizumab.Keywords
This publication has 13 references indexed in Scilit:
- Trajectory of fatigue severity in natalizumab treated multiple sclerosis patientsClinical Neurology and Neurosurgery, 2013
- Impact of Natalizumab on Cognitive Performances and Fatigue in Relapsing Multiple Sclerosis: A Prospective, Open-Label, Two Years Observational StudyPLOS ONE, 2012
- Multiple Sclerosis-Associated Fatigue during Disease-Modifying Treatment with Natalizumab, Interferon-Beta and Glatiramer AcetateEuropean Neurology, 2011
- Evaluation of the symbol digit modalities test (SDMT) and MS neuropsychological screening questionnaire (MSNQ) in natalizumab-treated MS patients over 48 weeksMultiple Sclerosis Journal, 2010
- Multiple sclerosis associated fatigue during natalizumab treatmentJournal of the Neurological Sciences, 2009
- Natalizumab treatment is associated with peripheral sequestration of proinflammatory T cellsNeurology, 2009
- Effect of plasma exchange in accelerating natalizumab clearance and restoring leukocyte functionNeurology, 2009
- Health‐related quality of life in multiple sclerosis: effects of natalizumabAnnals of Neurology, 2007
- A Randomized, Placebo-Controlled Trial of Natalizumab for Relapsing Multiple SclerosisThe New England Journal of Medicine, 2006
- A health-related quality of life measure for multiple sclerosisQuality of Life Research, 1995