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To address the question of disease activity after cessation of Tysabri, Olaf Stuve, MD, PhD (VA North Texas Health Care System, Dallas) and collaborators conducted an investigator-initiated study (not funded by the drug’s sponsor) evaluating immune activity in the blood and spinal fluid, relapse rates and disease progression, and MRI scans 14 months after the cessation of Tysabri. They found that at 14 months, most were stable, with no new clinical disease activity, MRI activity or immune activity. In an accompanying editorial, Drs. Nicoline Schiess and Peter Calabresi comment that, based on this and previous studies, stopping Tysabri after extended dosing may not cause rebound, whereas stopping the drug after only a few doses may indeed cause disease worsening.