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, Jose C
A1 Izquierdo, Guillermo
A1 Paramo, Dolores
A1 Oliva, Pedro
A1 Casanova, Bonaventura
A1 Aguera-Morales, Eduardo
A1 Franciotta, Diego
A1 Gastaldi, Matteo
A1 Fernandez, Oscar
A1 Urbaneja, Patricia
A1 Garcia-Dominguez, Jose 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 Gonzalez, Ines
A1 Alvarez, Elena
A1 Ramo, Cristina
A1 Caminero, Ana B
A1 Aladro, Yolanda
A1 Calles, Carmen
A1 Eguia, Pablo
A1 Belenguer-Benavides, Antonio
A1 Ramio-Torrenta, Lluis
A1 Quintana, Ester
A1 Martinez-Rodriguez, Jose E
A1 Oterino, Agustín
A1 Lopez-de-Silanes, Carlos
A1 Casanova, Luis I
A1 Landete, Lamberto
A1 Frederiksen, Jette
A1 Bsteh, Gabriel
A1 Mulero, Patricia
A1 Comabella, Manuel
A1 Hernandez, Miguel A
A1 Espiño, Mercedes
A1 Prieto, Jose M
A1 Perez, Domingo
A1 Otano, Maria
A1 Padilla, Francisco
A1 Garcia-Merino, Juan A
A1 Navarro, Laura
A1 Muriel, Alfonso
A1 Costa-Frossard, Lucienne
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 <1/10,000 in patients younger than 45 years at natalizumab initiation, who showed anti John Cunningham virus antibody indices <0.9 and lipid-specific IgM oligoclonal bands to 1/33 in the opposite case.
PB Frontiers Research Foundation
SN 1664-2295
YR 2020
FD 2020-12-17
LK http://hdl.handle.net/10668/16933
UL http://hdl.handle.net/10668/16933
LA en
NO Toboso I, Tejeda-Velarde A, Alvarez-Lafuente R, Arroyo R, Hegen H, Deisenhammer F, et al. New Algorithms Improving PML Risk Stratification in MS Patients Treated With Natalizumab. Front Neurol. 2020 Dec 17;11:579438
DS RISalud
RD Sep 22, 2025