[Progressive multifocal leukoencephalopathy under natalizumab. Initial possibilities for risk stratification?].
Natalizumab (Tysabri®) is the first monoclonal antibody approved for the treatment of relapsing forms of multiple sclerosis (MS) but while treatment is highly efficient, it carries the risk of progressive multifocal leukoencephalopathy (PML). Based on reports of confirmed cases of PML, the risk of PML might increase beyond 24 months of treatment. Thus, attempts to stratify patients treated with natalizumab into those carrying higher or lower risk for developing PML are currently being undertaken. Among these strategies JC virus serology might potentially be the first tool available. As a large variety of methods have been published resulting in controversial results for JC virus seroprevalence, standardized testing will be mandatory when applying this method in clinical practice. In addition, risk management strategies for the seropositive majority of patients need to be redefined and optimized further.
Neurologische Klinik, Heinrich-Heine-Universität, Moorenstr. 5, 40225, Düsseldorf.
C
C
Warnke
O
O
Adams
R
R
Gold
H-P
HP
Hartung
R
R
Hohlfeld
H
H
Wiendl
B C
BC
Kieseier
D000911:Antibodies, Monoclonal / Q000009:adverse effects* / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D006801:Humans; D007968:Leukoencephalopathy, Progressive Multifocal / Q000139:chemically induced* / Q000175:diagnosis / Q000517:prevention & control*; D009103:Multiple Sclerosis / Q000150:complications / Q000188:drug therapy*; D000069442:Natalizumab; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000069442:Natalizumab
J Med Virol. 2003 Sep;71(1):115-23
12858417
J Neurol. 2008 Oct;255(10):1449-63
19005625
Ann Neurol. 2010 Sep;68(3):304-10
20737514
Ann Neurol. 2006 May;59(5):743-7
16634029
N Engl J Med. 2006 Mar 2;354(9):924-33
16510746
N Engl J Med. 2006 Mar 2;354(9):899-910
16510744
Lancet Neurol. 2010 Mar;9(3):264-72
20117055
Gut. 2008 Oct;57(10):1393-7
18436577
J Neurol. 2010 Jun;257(6):954-8
20052484
Lancet Neurol. 2010 Apr;9(4):438-46
20298967
Ann Neurol. 2008 Oct;64(4):379-87
18688812
Lancet Neurol. 2009 Jan;8(1):28-31
19081511
Adv Exp Med Biol. 2006;577:19-45
16626025
Lancet Neurol. 2010 Mar;9(3):231-3
20117056
N Engl J Med. 2009 Sep 10;361(11):1081-7
19741229
J Med Virol. 2010 Mar;82(3):494-504
20087944
Lancet Neurol. 2007 May;6(5):431-41
17434098
N Engl J Med. 2009 Sep 10;361(11):1075-80
19741228
PLoS Pathog. 2009 Mar;5(3):e1000363
19325891
J Infect Dis. 2003 May 15;187(10):1571-80
12721937
N Engl J Med. 2006 Mar 2;354(9):911-23
16510745
Ann Neurol. 2010 Sep;68(3):295-303
20737510
N Engl J Med. 2005 Jul 28;353(4):362-8
15947080
J Infect Dis. 2009 Mar 15;199(6):837-46
19434930
Arch Neurol. 2006 Oct;63(10):1383-7
17030653
J Gen Virol. 2003 Jun;84(Pt 6):1499-1504
12771419
N Engl J Med. 2009 Sep 10;361(11):1067-74
19741227
N Engl J Med. 2009 Dec 17;361(25):2489; author reply 2489-90
20050216
J Virol. 1998 Dec;72(12):9918-23
9811728
Nervenarzt. 2009 Oct;80(10):1143-4, 1146-8, 1150-3
19357826
N Engl J Med. 2005 Jul 28;353(4):375-81
15947078
J Clin Microbiol. 1997 May;35(5):1255-7
9114418
N Engl J Med. 2009 Sep 10;361(11):1041-3
19741226
N Engl J Med. 2009 Dec 17;361(25):2487-8; author reply 2489-90
20018972
Lancet Neurol. 2010 Jun;9(6):565-6; author reply 566-7
20494320