Severe CNS inflammation after discontinuation of natalizumab and start of daclizumab successfully treated with alemtuzumab

Publication date: Available online 29 March 2018 Source:Multiple Sclerosis and Related Disorders Author(s): Martin W. Hümmert, Julian Deppe, Refik Pul, Ulrich Wurster, Philipp Schwenkenbecher, Kurt-Wolfram Sühs, Paul Bronzlik, Martin Stangel, Thomas Skripuletz Natalizumab is highly effective in the treatment of relapsing multiple sclerosis patients. Unfortunately, after stopping natalizumab, there is an increased risk of inflammation in the central nervous system and relapses. Switching from natalizumab to an alternative sufficient drug may prevent disease reactivation. Here we present a case of a patient who experienced a dramatic course with severe central nervous system inflammation after discontinuation of natalizumab and treatment initiation with daclizumab. During a treatment of 36 days, 20g intravenous methylprednisolone in total and ten courses of plasmapheresis were not able to control the severe CNS inflammation. Alemtuzumab, which targets the whole lymphocyte population, was able to stabilize the devastating disease course in our case.
Source: Multiple Sclerosis and Related Disorders - Category: Neurology Source Type: research