@article{discovery10186117,
         journal = {Multiple Sclerosis Journal},
           title = {Exploring the effects of extended interval dosing of natalizumab and drug concentrations on brain atrophy in multiple sclerosis},
            year = {2024},
           month = {January},
            note = {{\copyright} The Author(s) 2024. This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/).},
        keywords = {Multiple sclerosis, brain atrophy, drug concentration, extended interval dosing, natalizumab},
          author = {Toorop, Alyssa A and Noteboom, Samantha and Steenwijk, Martijn D and Gravendeel, Job W and Jasperse, Bas and Barkhof, Frederik and Strijbis, Eva Mm and Rispens, Theo and Schoonheim, Menno M and van Kempen, Zo{\'e} LE and Killestein, Joep},
        abstract = {BACKGROUND: Extended interval dosing (EID) of natalizumab treatment is increasingly used in multiple sclerosis. Besides the clear anti-inflammatory effect, natalizumab is considered to have neuroprotective properties as well. OBJECTIVES: This study aimed to study the longitudinal effects of EID compared to standard interval dosing (SID) and natalizumab drug concentrations on brain atrophy. METHODS: Patients receiving EID or SID of natalizumab with a minimum radiological follow-up of 2 years were included. Changes in brain atrophy measures over time were derived from clinical routine 3D-Fluid Attenuated Inversion Recovery (FLAIR)-weighted magnetic resonance imaging (MRI) scans using SynthSeg. RESULTS: We found no differences between EID (n = 32) and SID (n = 50) for whole brain (-0.21\% vs -0.16\%, p = 0.42), ventricular (1.84\% vs 1.13\%, p = 0.24), and thalamic (-0.32\% vs -0.32\%, p = 0.97) annualized volume change over a median follow-up of 3.2 years. No associations between natalizumab drug concentration and brain atrophy rate were found. CONCLUSION: We found no clear evidence that EID compared to SID or lower natalizumab drug concentrations have a negative impact on the development of brain atrophy over time.},
             url = {https://doi.org/10.1177/13524585231225855}
}