P028 - The risk of short-term relapse in patients switching from natalizumab to fingolimod

Abstract

Background Risk stratification is an important pillar in treating high-risk multiple sclerosis (MS) patients. In JC virus seropositive patients, switching natalizumab to fingolimod is often considered after analyzing the risk versus benefit ratio. Objectives To determine the short-term risk of relapse after switching natalizumab to fingolimod in MS patients, and to assess its association with demographic and clinical parameters. Methods Data of MS patients who were prescribed fingolimod and natalizumab were extracted from the national MS registry. Demographics, clinical characteristics and duration of disease modifying therapies were collected. The risk of relapse of patients who were switched from natalizumab to fingolimod was compared to non-switchers. A multivariate analysis of specific demographics and clinical characteristics was conducted. Results Twenty nine patients were switched from natalizumab to fingolimod due to JC virus seropositivity. The mean duration of fingolimod exposure was 8.8 months. Men were more likely to continue on natalizumab (20.7% versus 41.7%; P=0.04). The mean disease duration was significantly higher in the switcher group (10.9 versus 6.29; P Conclusions The short-term risk of relapse in patients switched to fingolimod was higher than those who continued natalizumab. Switchers were more likely to be women and had longer disease duration. Patients, who stayed longer on natalizumab before switching to fingolimod and had short washout periods, had lower rates of relapses. Further studies are needed to assess the long-term risk of relapses in patients who switched from natalizumab to fingolimod.