Improving risk‐stratification of natalizumab‐associated PML
| Autor: | Joseph R. Berger, Bastian Tugemann |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
0301 basic medicine
Oncology Canada medicine.medical_specialty Multiple Sclerosis viruses Neurosciences. Biological psychiatry. Neuropsychiatry Brief Communication Antibodies Viral Risk Assessment 03 medical and health sciences 0302 clinical medicine Natalizumab Internal medicine medicine Humans Immunologic Factors Dosing RC346-429 business.industry General Neuroscience Multiple sclerosis Progressive multifocal leukoencephalopathy Incidence (epidemiology) Leukoencephalopathy Progressive Multifocal medicine.disease JC Virus United States Europe 030104 developmental biology Risk stratification Neurology. Diseases of the nervous system Neurology (clinical) Brief Communications business Algorithms 030217 neurology & neurosurgery RC321-571 medicine.drug |
| Zdroj: | Annals of Clinical and Translational Neurology Annals of Clinical and Translational Neurology, Vol 8, Iss 3, Pp 696-703 (2021) |
| ISSN: | 2328-9503 |
| DOI: | 10.1002/acn3.51130 |
| Popis: | Based on publicly available data, we reevaluated current algorithms for stratifying the risk of progressive multifocal leukoencephalopathy (PML) in natalizumab‐treated patients with multiple sclerosis, and found that there are a number of issues. First and foremost, our analysis highlights the necessity of separate PML incidence assessments for the U.S. versus Europe, and indicates that the risk in John Cunningham virus (JCV) antibody‐negative patients may be higher than previously communicated. Additionally, we advocate introducing a low‐risk JCV index threshold of 0.45 for individuals with prior exposure to an immunosuppressant, and setting the low‐risk threshold at 0.6 instead of 0.9 for those without such pretherapies. On the other hand, the risk of PML on natalizumab, in general, appears to not only plateau but to actually decrease after about 5 years of continuous dosing. |
| Databáze: | OpenAIRE |
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