Successful treatment of highly active multiple sclerosis and psoriasis exacerbation with natalizumab and secukinumab combination. A case report and literature review

This article discusses the history of natalizumab (Tysabri), the first monoclonal antibody used to treat multiple sclerosis. It reviews how the medication's difficult beginnings and controversial past have changed how this treatment is monitored. The article looks at the role of clinicians in maintaining patient safety, the benefits and risk profile of this treatment and ways of optimising practice to provide gold standard nationalised natalizumab services throughout the UK.

Download Full-text

Highly active multiple sclerosis: An update

Multiple Sclerosis and Related Disorders ◽

10.1016/j.msard.2019.01.039 ◽

2019 ◽

Vol 30 ◽

pp. 215-224 ◽

Cited By ~ 22

Author(s):

Cindy Díaz ◽

Luis Alfonso Zarco ◽

Diego M. Rivera

Keyword(s):

Multiple Sclerosis ◽

Highly Active ◽

Highly Active Multiple Sclerosis ◽

Active Multiple Sclerosis

Download Full-text

Elevated D-dimer as an immediate response to alemtuzumab treatment

Multiple Sclerosis Journal ◽

10.1177/1352458520904277 ◽

2020 ◽

Vol 27 (1) ◽

pp. 151-154 ◽

Cited By ~ 1

Author(s):

Jana Libertinova ◽

Eva Meluzinova ◽

Eva Nema ◽

Petra Rockova ◽

Martin Elisak ◽

...

Keyword(s):

Multiple Sclerosis ◽

Adverse Reactions ◽

Low Molecular Weight ◽

Frequent Adverse Event ◽

Highly Active ◽

Thrombotic Complications ◽

Multiple Sclerosis Patients ◽

Highly Active Multiple Sclerosis ◽

D Dimer ◽

Active Multiple Sclerosis

Alemtuzumab as a treatment of highly active multiple sclerosis causes a rapid decrease in inflammatory activity due the lysis of immune cells. Subsequent cytokine release determines the infusion-associated reaction that is a frequent adverse event of alemtuzumab treatment. Recently, serious cardiovascular and thrombotic adverse reactions following alemtuzumab infusion have been described. In our study, the dynamics of coagulation parameters were analyzed in 13 multiple sclerosis patients treated with alemtuzumab. An immediate, significant increase in the level of D-dimer was observed after the first administration of alemtuzumab. This observation provides evidence of coagulation activation and the potential risk of thrombotic complications with this therapy. Prophylactic low molecular weight heparin pretreatment maybe considered in patients receiving alemtuzumab.

Download Full-text

EARLY RELAPSES IN PATIENTS WITH HIGHLY ACTIVE MULTIPLE SCLEROSIS COMMENCED ON FINGOLIMOD; THE LEEDS TEACHING HOSPITAL EXPERIENCE

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp-2015-312379.123 ◽

2015 ◽

Vol 86 (11) ◽

pp. e4.28-e4

Author(s):

Kalani Chisha Weerasinghe ◽

Priya Shanmugarajah ◽

Melanie Russell ◽

Helen Ford

Keyword(s):

Multiple Sclerosis ◽

Patient Choice ◽

Oral Disease ◽

Highly Active ◽

Previously Treated ◽

Disease Modifying ◽

Disease Modifying Treatment ◽

Highly Active Multiple Sclerosis ◽

Active Disease ◽

Active Multiple Sclerosis

Fingolimod is the much anticipated oral disease modifying treatment for patients with highly active Multiple sclerosis. A total of 42 patients were commenced on Fingolimod from December 2012 to June 2014 in Leeds Hospitals NHS Trust.Four patients discontinued treatment due to patient choice, consecutive severe relapses and hepatotoxicity. No other severe side effects were noted in these 42 patients. A total of ten relapses were seen in nine patients. Of which eight out of ten relapses occurred within the first two months. Of the nine patients who experienced relapses, five (55%) were previously treated with Natalizumab, as opposed to four on injectable Disease Modifying Treatments (45%).The five patients previously treated with Natalizumab all underwent a three month wash out period prior to commencing Fingolimod. The relapses all took place within the first two months following initiation of Fingolimod.Early relapses in a patient group with highly active disease would suggest that a period of three months without disease modifying treatment could be too long. Currently this period has been shortened to four weeks and it remains to be seen if this will result in fewer early relapses in patients commencing Fingolimod.

Download Full-text