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• Vol.59 No.8
• CLINICA NEUROL, 59: 536−540, 2019
• Vol.59 No.8 contents

Case Report

Increased disease activity in a case of multiple sclerosis after switching treatment from fingolimod to natalizumab

Ritsu Akatani, M.D.¹⁾, Norio Chihara, M.D., Ph.D.¹⁾, Kimitaka Katanazaka, M.D.¹⁾, Takehiro Ueda, M.D., Ph.D.¹⁾, Kenji Sekiguchi, M.D., Ph.D.¹⁾ and Riki Matsumoto, M.D., Ph.D.¹⁾

¹⁾Division of Neurology, Kobe University Graduate School of Medicine

A 42-year-old woman diagnosed with multiple sclerosis (MS) at the age of 37 was initially treated with interferon-β IM. The frequency of clinical relapses was twice in 4 years. At the age of 41, due to difficulty in administering muscle injections, an oral medication fingolimod was started. However, it was discontinued after a month due to decreased lymphocyte count, following which natalizumab was administered. The number of relapses increased 3 times in eleven months, and the number of T₂ lesions on the MRI increased from 12 to 23. Natalizumab was discontinued because the test for the anti-natalizumab antibody was positive. It was suspected that both, the rebound syndrome caused by fingolimod cessation and the drug neutralization by anti-natalizumab antibodies, were associated with the exacerbation of disease activity. Thus, careful attention should be paid to potential occurrence of these events post switching between disease-modifying drugs for treating MS with high activity.
Full Text of this Article in Japanese PDF (546K)

(CLINICA NEUROL, 59: 536−540, 2019)
key words: multiple sclerosis, anti-natalizumab antibody, natalizumab, fingolimod, rebound syndrome

(Received: 1-Apr-19)