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Nervenheilkunde 2014; 33(04): 295-298
DOI: 10.1055/s-0038-1633395
Kasuistik
Schattauer GmbH

Stabiler Verlauf einer hochaktiven schubförmigen MS unter Natalizumab seit mehr als 4 Jahren

Stable disease course of a patient with highly active relapsing-remitting multiple sclerosis for more than 4 years
T. Ruck
1   Department für Neurologie, Klinik für Allgemeine Neurologie, Westfälische-Wilhelms-Universität, Münster
,
S. Meuth
1   Department für Neurologie, Klinik für Allgemeine Neurologie, Westfälische-Wilhelms-Universität, Münster
› Author Affiliations
Further Information

Publication History

eingegangen am: 04 February 2014

angenommen am: 07 February 2014

Publication Date:
02 February 2018 (online)

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Zusammenfassung

Gegenstand und Ziel: Anhand eines Fallberichtes einer Patientin mit einer hochaktiven schubförmigen Multiplen Sklerose, deren Erkrankung unter einer Langzeittherapie mit Natalizumab anhaltend stabilisiert werden konnte, sollen die Überlegungen zu Nutzen und Risiken der Natalizumabtherapie verdeutlicht werden. Material und Methoden: Dem Fallbericht werden Anamnese, klinische Befunde sowie MRT-Aufnahmen zugrunde gelegt. Ergebnisse: Unter der Therapie mit Natalizumab konnte eine anhaltende Stabilisierung des Krankheitsverlaufes ohne klinische und paraklinische Krankheitsaktivität über den Zeitraum von 54 Infusionszyklen erreicht werden. Bis auf nicht behandlungsbedürftige Infektionskrankheiten konnten keine schweren Nebenwirkungen eruiert werden. Schlussfolgerungen/klinische Relevanz: Eine langjährige Therapie mit Natalizumab, über 24 Monate hinweg, ist abhängig vom initialen Krankheitsverlauf, dem Ansprechen auf die Therapie, der Risikostratifzierung einer PML und dem individuellen Patientenwunsch auch trotz erhöhter Risiken zu erwägen.

Summary

Objective: A case report of a patient with highly active relapsing-remitting multiple sclerosis and diminished clinical and MRI disease activity under therapy with natalizumab over more than 4 years, is used to illustrate the process of risk stratification. Materials and methods: The case report is based on medical history, clinical investigation and MRI findings. Results: Therapy with natalizumab led to diminished clinical and MRI disease activity over 54 cycles of infusion. Besides mild infections without the need of specific therapy, no severe adverse events were observed. Conclusions/clinical relevance: Long-term therapy with natalizumab is associated with increased risk, disease course/ activity, individual PML risk and patients will have to be taken into account when deciding on (dis)continuation of therapy.

Schlüsselwörter

Natalizumab - Langzeittherapie - Stabilisierung des Krankheitsverlaufes

Keywords

Natalizumab - long term therapy - stable disease course
 

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