RT Journal Article T1 New Algorithms Improving PML Risk Stratification in MS Patients Treated With Natalizumab. A1 Toboso, Inmaculada A1 Tejeda-Velarde, Amalia A1 Alvarez-Lafuente, Roberto A1 Arroyo, Rafael A1 Hegen, Harald A1 Deisenhammer, Florian A1 Sainz de la Maza, Susana A1 Alvarez-Cermeño, José C A1 Izquierdo, Guillermo A1 Paramo, Dolores A1 Oliva, Pedro A1 Casanova, Bonaventura A1 Agüera-Morales, Eduardo A1 Franciotta, Diego A1 Gastaldi, Matteo A1 Fernández, Oscar A1 Urbaneja, Patricia A1 Garcia-Dominguez, José M A1 Romero, Fernando A1 Laroni, Alicia A1 Uccelli, Antonio A1 Perez-Sempere, Angel A1 Saiz, Albert A1 Blanco, Yolanda A1 Galimberti, Daniela A1 Scarpini, Elio A1 Espejo, Carmen A1 Montalban, Xavier A1 Rasche, Ludwig A1 Paul, Friedemann A1 González, Inés A1 Álvarez, Elena A1 Ramo, Cristina A1 Caminero, Ana B A1 Aladro, Yolanda A1 Calles, Carmen A1 Eguía, Pablo A1 Belenguer-Benavides, Antonio A1 Ramió-Torrentà, Lluis A1 Quintana, Ester A1 Martínez-Rodríguez, José E A1 Oterino, Agustín A1 López de Silanes, Carlos A1 Casanova, Luis I A1 Landete, Lamberto A1 Frederiksen, Jette A1 Bsteh, Gabriel A1 Mulero, Patricia A1 Comabella, Manuel A1 Hernández, Miguel A A1 Espiño, Mercedes A1 Prieto, José M A1 Pérez, Domingo A1 Otano, María A1 Padilla, Francisco A1 García-Merino, Juan A A1 Navarro, Laura A1 Muriel, Alfonso A1 Frossard, Lucienne Costa A1 Villar, Luisa M K1 biomarkers K1 demyelinating diseases K1 disease modifying treatments K1 multiple sclerosis K1 natalizumab K1 progressive multifocal leucoencephalopathy AB Overview: We assessed the role of age and disease activity as new factors contributing to establish the risk of progressive multifocal leucoencephalopathy in multiple sclerosis patients treated with natalizumab in 36 University Hospitals in Europe. We performed the study in 1,307 multiple sclerosis patients (70.8% anti-John Cunninghan virus positive antibodies) treated with natalizumab for a median time of 3.28 years. Epidemiological, clinical, and laboratory variables were collected. Lipid-specific IgM oligoclonal band status was available in 277 patients. Factors associated with progressive multifocal leucoencephalopathy onset were explored by uni- and multivariate logistic regression. Results: Thirty-five patients developed progressive multifocal leucoencephalopathy. The multivariate analysis identified anti-John Cunninghan virus antibody indices and relapse rate as the best predictors for the onset of this serious opportunistic infection in the whole cohort. They allowed to stratify progressive multifocal leucoencephalopathy risk before natalizumab initiation in individual patients [area under the curve (AUC) = 0.85]. The risk ranged from 0.5, to 1/50 in the opposite case. In patients with lipid-specific IgM oligoclonal bands assessment, age at natalizumab onset, anti-John Cunninghan virus antibody indices, and lipid-specific IgM oligoclonal band status predicted progressive multifocal leucoencephalopathy risk (AUC = 0.92). The absence of lipid-specific IgM oligoclonal bands was the best individual predictor (OR = 40.94). The individual risk ranged from SN 1664-2295 YR 2020 FD 2020-12-17 LK https://hdl.handle.net/10668/27663 UL https://hdl.handle.net/10668/27663 LA en DS RISalud RD Apr 10, 2025