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Innovations in MS care to improve individual disease management

Tailoring MS treatment dosing

Read time: 30 mins
Last updated:2nd Sep 2021
Published:11th Nov 2020

Discover how innovative new research is allowing healthcare professionals to tailor natalizumab dosing and decision making to address specific patients and their needs. Read below to learn how:

  • Tracking real-world use of natalizumab led to the discovery that changing the frequency of dosing could be a strategy to improve the safety of natalizumab in anti-JCV antibody positive (anti-JCV Ab+) multiple sclerosis (MS) patients*
  • Exploring additional patient centric outcomes is providing healthcare professionals with a better understanding of the right patient and right timing for use of natalizumab according to their disease characteristics

A large number of disease-modifying treatments are now available to treat MS patients and with each of these treatments there is a unique benefit risk balance to consider. Innovative new research is now allowing treatments to be tailored to individual patients. This is improving patient care by addressing specific patient situations and helping to meet the individual needs of patients.

Presented by Professor Sven Meuth, this section of the symposium answers the question: What important new research should be considered when tailoring the use of natalizumab?

Professor Sven Meuth is Director of the Institute of Translational Neurology and Vice-chair of the Department of Neurology at the University of Münster, Münster, Germany.

The TOUCH registry analysis: comparing natalizumab EID to SID

Professor Sven Meuth describes the results of the TOUCH registry analysis, a study that used data from the US risk evaluation and mitigation program to assess whether patients receiving fewer infusions in the past 18 months (extended interval dosing or EID) than those receiving "standard interval dosing (SID)" where at a lower risk of PML.

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The NOVA study: Evaluating the efficacy of extended interval dosing

Professor Sven Meuth discusses the phase 3b NOVA study – an interventional study evaluating the efficacy, safety and tolerability of every six-week (Q6W) dosing of natalizumab compared to every four-week (Q4W) dosing in relapsing-remitting multiple sclerosis (MS) over 72 weeks.

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Onset of efficacy with natalizumab

A benefit/risk ratio should take into account the efficacy of a disease modifying therapy. In this video, Professor Sven Meuth introduces the body of evidence for natalizumab treatment outcomes and considers the clinical implications of some of the data obtained in the phase 2 efficacy and dose finding study of natalizumab.

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Introducing the concept of improvement in disability and investigating different EDSS functional systems

Professor Sven Meuth shares the results of the Tysabri Observational Program (TOP) study, for which most sites are in Europe, which assessed the effect of natalizumab in real world use. He focuses on the impact of natalizumab treatment over 10 years on disability, per the expanded disability status scale (EDSS), and delves into individual functional systems. He specifically looks at the effect of natalizumab on visual and bladder function from the AFFIRM Phase 3 and TRUST observational studies, respectively, given the importance these functions have on quality of life.

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Improvements in additional readout parameters and patient-centred outcomes

Professor Sven Meuth shares more data on new readout parameters not commonly used in clinical trials, like fatigue in the ENER-G study, and formal SDMT testing for cognitive function in the Swedish registry.

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Are improvements in disability more likely if natalizumab is used earlier vs later?

Returning to the European-based TOP study,1 Professor Sven Meuth answers the question – does the time between multiple sclerosis symptom onset and natalizumab treatment affect the percentage of treatment naïve patients showing expanded disability status scale (EDSS) improvement?

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How does a longer time before treatment affect newer measures of disability?

Professor Sven Meuth discusses a US-based analysis1, derived from the multiple sclerosis performance test (MSPT) using the TOUCH population in MS PATHS, which compared earlier use of natalizumab against later use of natalizumab in patients matched for the duration of treatment with natalizumab.

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