High cumulative JC virus seroconversion rate during long-term use of natalizumab
| Autor: | Cyra E. Leurs, B. M. J. Uitdehaag, Anke Vennegoor, Mike P. Wattjes, Jean-Luc Murk, Joep Killestein, Theo Rispens, J.H.A. van Rossum |
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| Přispěvatelé: | Neurology, Amsterdam Neuroscience - Neuroinfection & -inflammation, Radiology and nuclear medicine, Medical Microbiology and Infection Prevention, Landsteiner Laboratory |
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male Pediatrics medicine.medical_specialty JC virus Antibodies Viral medicine.disease_cause Risk Assessment 03 medical and health sciences Multiple Sclerosis Relapsing-Remitting 0302 clinical medicine Natalizumab Risk Factors Humans Immunologic Factors Medicine 030212 general & internal medicine Risk factor Seroconversion business.industry Progressive multifocal leukoencephalopathy Multiple sclerosis Leukoencephalopathy Progressive Multifocal Middle Aged medicine.disease JC Virus Neurology Immunology Cohort Female Neurology (clinical) Risk assessment business 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | European Journal of Neurology, 23(6), 1079-1085. Wiley-Blackwell Vennegoor, A, van Rossum, J A, Leurs, C, Wattjes, M P, Rispens, T, Murk, J L A N, Uitdehaag, B M J & Killestein, J 2016, ' High cumulative JC virus seroconversion rate during long-term use of natalizumab ', European Journal of Neurology, vol. 23, no. 6, pp. 1079-1085 . https://doi.org/10.1111/ene.12988 European journal of neurology, 23(6), 1079-1085. Wiley-Blackwell |
| ISSN: | 1351-5101 |
| DOI: | 10.1111/ene.12988 |
| Popis: | Background and purposeJohn Cunningham virus (JCV) seropositivity is a risk factor for the development of natalizumab‐associated progressive multifocal leukoencephalopathy (PML) in multiple sclerosis (MS) patients. When JCV seronegative patients seroconvert, their risk of developing PML increases. Limited longitudinal data exist about the seroconversion rate amongst natalizumab‐treated relapsing−remitting MS (RRMS) patients. Our objective was to evaluate the seroconversion rate in a large Dutch cohort of natalizumab‐treated RRMS patients. Seroconversion was defined as at least two consecutive seropositive serum samples (or cessation of therapy after a single seropositive sample because of seropositivity) after initial seronegative testing.Methods and resultsIn our study of 179 patients for whom longitudinal blood samples were available over a long period (median 4.2 years), anti‐JCV antibody indices were measured in 933 available samples. Eighty‐six patients (48.0%) tested seronegative initially. Of these 86 seronegative patients, 23 patients (26.7%) seroconverted during follow‐up. The annualized seroconversion rate was 7.1%. Seroconversion occurred between 9 and 90 months (median 43 months) of treatment. The rate of seroconversion was independent of follow‐up duration. No significant increase was seen in the anti‐JCV antibody index in the non‐converting patients during the follow‐up.ConclusionThe annualized seroconversion rate of 7.1% in patients using natalizumab, cumulatively leading to more than 25% of seronegative patients becoming seropositive in 4 years, is of clinical relevance and should be taken into account in the risk assessment when considering the start of natalizumab therapy. |
| Databáze: | OpenAIRE |
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