title: Progressive multifocal leukoencephalopathy associated to natalizumab extended dosing regimen.
abstract: A risk for developing progressive multifocal leukoencephalopathy is a major barrier to natalizumab use. Extended dosing intervals have been proposed as a way to maintain therapeutic efficacy and reduce progressive multifocal leukoencephalopathy incidence. This is the first reported case of progressive multifocal leukoencephalopathy in a patient using an extended dosing regimen (300 mg/6 weeks). A close clinical and imaging monitoring allowed early detection, which is a major prognostic factor. A favorable outcome was seen with a therapy comprising plasma exchange therapy, mirtazapine, mefloquine and cidofovir. Further studies will be needed to assess the potential role of extended dosing intervals to improve prognosis in patients receiving natalizumab and also to measure its impact clinically and/or radiologically.
authors.affiliation: Department of Neurosciences, Multiple Sclerosis Unit, Germans Trias i Pujol Hospital. C/Canyet s/n 08916, Badalona, Spain.
authors.forename: José Vicente
authors.initials: JV
authors.lastname: Hervás
authors.affiliation: Department of Neurosciences, Multiple Sclerosis Unit, Germans Trias i Pujol Hospital. C/Canyet s/n 08916, Badalona, Spain.
authors.forename: Silvia
authors.initials: S
authors.lastname: Presas-Rodríguez
authors.affiliation: Department of Neurosciences, Multiple Sclerosis Unit, Germans Trias i Pujol Hospital. C/Canyet s/n 08916, Badalona, Spain.
authors.forename: Ane Miren
authors.initials: AM
authors.lastname: Crespo-Cuevas
authors.affiliation: Department of Neurosciences, Multiple Sclerosis Unit, Germans Trias i Pujol Hospital. C/Canyet s/n 08916, Badalona, Spain.
authors.forename: Tamara
authors.initials: T
authors.lastname: Canento
authors.affiliation: Department of Neurosciences, Multiple Sclerosis Unit, Germans Trias i Pujol Hospital. C/Canyet s/n 08916, Badalona, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Lozano-Sánchez
authors.affiliation: Department of Neurosciences, Multiple Sclerosis Unit, Germans Trias i Pujol Hospital. C/Canyet s/n 08916, Badalona, Spain.
authors.forename: Anna
authors.initials: A
authors.lastname: Massuet-Vilamajó
authors.affiliation: Department of Neurosciences, Multiple Sclerosis Unit, Germans Trias i Pujol Hospital. C/Canyet s/n 08916, Badalona, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Ramo-Tello
mesh_terms: D006801:Humans; D007155:Immunologic Factors / Q000008:administration & dosage* / Q000009:adverse effects; D007968:Leukoencephalopathy, Progressive Multifocal / Q000188:drug therapy / Q000209:etiology* / Q000821:virology; D008297:Male; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000188:drug therapy*; D000069442:Natalizumab / Q000008:administration & dosage* / Q000009:adverse effects; D013256:Steroids / Q000627:therapeutic use
chemical_list: D007155:Immunologic Factors; D000069442:Natalizumab; D013256:Steroids
keywords: extended dosing intervals; extended dosing regimen; multiple sclerosis; natalizumab; progressive multifocal leukoencephalopathy