TY - JOUR
T1 - Retinal atrophy in multiple sclerosis is similar with extended versus standard interval natalizumab therapy
AU - McCormack, Brenna
AU - Ezzedin, Omar
AU - Lin, Ting Yi
AU - Bacchetti, Anna
AU - Moretti, Giulia S.
AU - Lievers, Ernest
AU - Gulati, Ananya
AU - Davis, Simidele
AU - Otero-Duran, Gabriel
AU - Bonair, Devon J.
AU - Pellegrini, Nicole
AU - Gakis, Georgios
AU - Filippatou, Angeliki
AU - Lambert, Clare Mc Garvey
AU - O’Donnell, Martin Maurice
AU - Fitzgerald, Kathryn
AU - Sotirchos, Elias S.
AU - Calabresi, Peter A.
AU - Newsome, Scott D.
AU - Mowry, Ellen M.
AU - Saidha, Shiv
N1 - Publisher Copyright:
© The Author(s), 2026. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).
PY - 2026/7/1
Y1 - 2026/7/1
N2 - Background: Retinal ganglion cell + inner plexiform layer (GCIPL) atrophy reflects global neurodegeneration and disability in multiple sclerosis. Extended interval dosing (EID; every 5–8 weeks) natalizumab reduces progressive multifocal leukoencephalopathy risk in people with relapsing–remitting multiple sclerosis (PwRRMS) versus standard interval dosing (SID; every 4 weeks). Objectives: To assess if EID versus SID natalizumab differentially impacts GCIPL atrophy, other retinal layer (peripapillary retinal nerve fiber layer (pRNFL), inner nuclear layer (INL), and outer nuclear layer (ONL)) atrophy, and/or clinical outcomes in PwRRMS. Methods: PwRRMS underwent longitudinal Cirrus high-definition optical coherence tomography (OCT), expanded disability status scale (EDSS), 100% and 2.5% contrast letter-acuity (LA) assessments. Analyses utilized mixed-effects regression models adjusting for age, sex, race, disease duration, optic neuritis history, and interval between treatment initiation and OCT monitoring, accounting for within-subject, inter-eye correlations. Results: GCIPL and pRNFL atrophy rates were not significantly different between EID (n = 22) and SID (n = 109) natalizumab (p = 0.48, p = 0.24). INL and ONL atrophy were faster with EID versus SID natalizumab (p = 0.02, p < 0.001). Age was higher (44.8 vs. 40.1 years, p = 0.03) and disease duration longer (15.2 vs. 8.4 years, p < 0.001) in the EID natalizumab cohort. Annual EDSS and 100% and 2.5% LA changes were similar between cohorts. Conclusion: We detected no significant difference in GCIPL or pRNFL atrophy, or clinical outcomes, between EID and SID natalizumab. Faster INL and ONL atrophy may relate to cohort demographic differences.
AB - Background: Retinal ganglion cell + inner plexiform layer (GCIPL) atrophy reflects global neurodegeneration and disability in multiple sclerosis. Extended interval dosing (EID; every 5–8 weeks) natalizumab reduces progressive multifocal leukoencephalopathy risk in people with relapsing–remitting multiple sclerosis (PwRRMS) versus standard interval dosing (SID; every 4 weeks). Objectives: To assess if EID versus SID natalizumab differentially impacts GCIPL atrophy, other retinal layer (peripapillary retinal nerve fiber layer (pRNFL), inner nuclear layer (INL), and outer nuclear layer (ONL)) atrophy, and/or clinical outcomes in PwRRMS. Methods: PwRRMS underwent longitudinal Cirrus high-definition optical coherence tomography (OCT), expanded disability status scale (EDSS), 100% and 2.5% contrast letter-acuity (LA) assessments. Analyses utilized mixed-effects regression models adjusting for age, sex, race, disease duration, optic neuritis history, and interval between treatment initiation and OCT monitoring, accounting for within-subject, inter-eye correlations. Results: GCIPL and pRNFL atrophy rates were not significantly different between EID (n = 22) and SID (n = 109) natalizumab (p = 0.48, p = 0.24). INL and ONL atrophy were faster with EID versus SID natalizumab (p = 0.02, p < 0.001). Age was higher (44.8 vs. 40.1 years, p = 0.03) and disease duration longer (15.2 vs. 8.4 years, p < 0.001) in the EID natalizumab cohort. Annual EDSS and 100% and 2.5% LA changes were similar between cohorts. Conclusion: We detected no significant difference in GCIPL or pRNFL atrophy, or clinical outcomes, between EID and SID natalizumab. Faster INL and ONL atrophy may relate to cohort demographic differences.
KW - Multiple sclerosis
KW - demyelinating diseases
KW - natalizumab
KW - optical coherence tomography
KW - relapsing–remitting multiple sclerosis
KW - tysabri
UR - https://www.scopus.com/pages/publications/105046756797
UR - https://www.scopus.com/pages/publications/105046756797#tab=citedBy
U2 - 10.1177/20552173261475496
DO - 10.1177/20552173261475496
M3 - Article
C2 - 42571199
AN - SCOPUS:105046756797
SN - 2055-2173
VL - 12
JO - Multiple Sclerosis Journal - Experimental, Translational and Clinical
JF - Multiple Sclerosis Journal - Experimental, Translational and Clinical
IS - 3
ER -