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Multiple sclerosis

Progressive multifocal leukoencephalopathy risk stratification

A compelling need exists for a more reliable risk evaluation of natalizumab- associated progressive multifocal leukoencephalopathy (PML). A new report proposes a refined protocol that uses updated patient-based data and cumulative risk evaluation to provide an improved assessment of the annual risk of PML for patients positive for JC virus.

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References

  1. Biogen. TYSABRI® (natalizumab). Biogen https://medinfo.biogen.com/secure/pmlresource (2016).

  2. Hoepner, R. et al. Predictors of severity and functional outcome in natalizumab-associated progressive multifocal leukoencephalopathy. Mult. Scler. 23, 830–835 (2017).

    Article  Google Scholar 

  3. Ho, P. R. et al. Risk of natalizumab-associated progressive multifocal leukoencephalopathy in patients with multiple sclerosis: a retrospective analysis of data from four clinical studies. Lancet Neurol. 16, 925–933 (2017).

    CAS  Article  Google Scholar 

  4. Bloomgren, G. et al. Risk of natalizumab-associated progressive multifocal leukoencephalopathy. N. Engl. J. Med. 366, 1870–1880 (2012).

    CAS  Article  Google Scholar 

  5. Plavina, T. et al. Anti-JC virus antibody levels in serum or plasma further define risk of natalizumab-associated progressive multifocal leukoencephalopathy. Ann. Neurol. 76, 802–812 (2014).

    CAS  Article  Google Scholar 

  6. McGuigan, C. et al. Stratification and monitoring of natalizumab-associated progressive multifocal leukoencephalopathy risk: recommendations from an expert group. J. Neurol. Neurosurg. Psychiatry 87, 117–125 (2016).

    CAS  Article  Google Scholar 

  7. Borchardt, J. & Berger, J. R. Re-evaluating the incidence of natalizumab-associated progressive multifocal leukoencephalopathy. Mult. Scler. Relat. Disord. 8, 145–150 (2016).

    Article  Google Scholar 

  8. Kalincik, T. et al. Treatment effectiveness of alemtuzumab compared with natalizumab, fingolimod, and interferon beta in relapsing-remitting multiple sclerosis: a cohort study. Lancet Neurol. 16, 271–281 (2017).

    CAS  Article  Google Scholar 

  9. Schwab, N. et al. Natalizumab-associated PML: challenges with incidence, resulting risk, and risk stratification. Neurology 88, 1197–1205 (2017).

    CAS  Article  Google Scholar 

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Correspondence to Ralf Gold.

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Competing interests

K.P. received speaker honoraria and travel funding from Bayer Schering Pharma, Biogen Idec and Novartis. R.G. serves on scientific advisory boards for Bayer Schering Pharma, Biogen Idec, Novartis and Teva Pharmaceutical Industries Ltd; has received speaker honoraria from Bayer Schering Pharma, Biogen Idec, Novartis and Teva Pharmaceutical Industries Ltd; serves as editor for Therapeutic Advances in Neurological Disorders and on the editorial boards of Experimental Neurology and the Journal of Neuroimmunology; and receives research support from Bayer Schering Pharma, Biogen Idec, Genzyme, Merck Serono, Novartis and Teva Pharmaceutical Industries Ltd, none related to this manuscript.

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Pitarokoili, K., Gold, R. Progressive multifocal leukoencephalopathy risk stratification. Nat Rev Neurol 13, 710–712 (2017). https://doi.org/10.1038/nrneurol.2017.161

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