Natalizumab is an immune modulator that is effective for the treatment of relapsing-remitting multiple sclerosis. It is rarely associated with the development of potentially fatal progressive multifocal leukoencephalopathy (PML), the risk of which is thought to increase with longer duration of therapy. Some multiple sclerosis centers suspend administration of natalizumab for three or four months after one year of treatment in order to restore immune surveillance. However, limited data have raised concerns that this approach is associated with a high risk of sudden worsening or rebound of multiple sclerosis symptoms
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