Does risk stratification decrease the risk of natalizumab-associated PML? Where is the evidence?

Gary R. Cutter, Olaf Stüve

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

The use of natalizumab has likely been limited by its association with progressive multifocal leukoencephalopathy (PML), an infection caused by the human polyomavirus John Cunningham (JC). Three factors were recently identified that contribute to the overall risk of natalizumab-associated PML: (1) Positive serostatus for anti-JCV antibodies, (2) prior use of immunosuppressants, and (3) duration of natalizumab therapy. This risk stratification algorithm has not led to a reduction in the incidence of PML in natalizumab-treated patients with multiple sclerosis between April 2010 and February 2014. This observation may appear perplexing, as treatment duration and JCV serostatus are modifiable risk factors. Potential reasons for the lack of success of companion diagnostics that determine the overall risk of natalizumab-associated PML are discussed.

Original languageEnglish (US)
Pages (from-to)1304-1305
Number of pages2
JournalMultiple Sclerosis
Volume20
Issue number10
DOIs
StatePublished - Sep 1 2014

Fingerprint

Progressive Multifocal Leukoencephalopathy
Polyomavirus
Immunosuppressive Agents
Multiple Sclerosis
Anti-Idiotypic Antibodies
Natalizumab
Incidence
Therapeutics
Infection

Keywords

  • Disease-modifying therapies
  • multiple sclerosis
  • outcome measurement

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Does risk stratification decrease the risk of natalizumab-associated PML? Where is the evidence? / Cutter, Gary R.; Stüve, Olaf.

In: Multiple Sclerosis, Vol. 20, No. 10, 01.09.2014, p. 1304-1305.

Research output: Contribution to journalArticle

@article{ca130b95daa746779b2a797440187940,
title = "Does risk stratification decrease the risk of natalizumab-associated PML? Where is the evidence?",
abstract = "The use of natalizumab has likely been limited by its association with progressive multifocal leukoencephalopathy (PML), an infection caused by the human polyomavirus John Cunningham (JC). Three factors were recently identified that contribute to the overall risk of natalizumab-associated PML: (1) Positive serostatus for anti-JCV antibodies, (2) prior use of immunosuppressants, and (3) duration of natalizumab therapy. This risk stratification algorithm has not led to a reduction in the incidence of PML in natalizumab-treated patients with multiple sclerosis between April 2010 and February 2014. This observation may appear perplexing, as treatment duration and JCV serostatus are modifiable risk factors. Potential reasons for the lack of success of companion diagnostics that determine the overall risk of natalizumab-associated PML are discussed.",
keywords = "Disease-modifying therapies, multiple sclerosis, outcome measurement",
author = "Cutter, {Gary R.} and Olaf St{\"u}ve",
year = "2014",
month = "9",
day = "1",
doi = "10.1177/1352458514531843",
language = "English (US)",
volume = "20",
pages = "1304--1305",
journal = "Multiple Sclerosis",
issn = "1352-4585",
publisher = "SAGE Publications Ltd",
number = "10",

}

TY - JOUR

T1 - Does risk stratification decrease the risk of natalizumab-associated PML? Where is the evidence?

AU - Cutter, Gary R.

AU - Stüve, Olaf

PY - 2014/9/1

Y1 - 2014/9/1

N2 - The use of natalizumab has likely been limited by its association with progressive multifocal leukoencephalopathy (PML), an infection caused by the human polyomavirus John Cunningham (JC). Three factors were recently identified that contribute to the overall risk of natalizumab-associated PML: (1) Positive serostatus for anti-JCV antibodies, (2) prior use of immunosuppressants, and (3) duration of natalizumab therapy. This risk stratification algorithm has not led to a reduction in the incidence of PML in natalizumab-treated patients with multiple sclerosis between April 2010 and February 2014. This observation may appear perplexing, as treatment duration and JCV serostatus are modifiable risk factors. Potential reasons for the lack of success of companion diagnostics that determine the overall risk of natalizumab-associated PML are discussed.

AB - The use of natalizumab has likely been limited by its association with progressive multifocal leukoencephalopathy (PML), an infection caused by the human polyomavirus John Cunningham (JC). Three factors were recently identified that contribute to the overall risk of natalizumab-associated PML: (1) Positive serostatus for anti-JCV antibodies, (2) prior use of immunosuppressants, and (3) duration of natalizumab therapy. This risk stratification algorithm has not led to a reduction in the incidence of PML in natalizumab-treated patients with multiple sclerosis between April 2010 and February 2014. This observation may appear perplexing, as treatment duration and JCV serostatus are modifiable risk factors. Potential reasons for the lack of success of companion diagnostics that determine the overall risk of natalizumab-associated PML are discussed.

KW - Disease-modifying therapies

KW - multiple sclerosis

KW - outcome measurement

UR - http://www.scopus.com/inward/record.url?scp=84907446851&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84907446851&partnerID=8YFLogxK

U2 - 10.1177/1352458514531843

DO - 10.1177/1352458514531843

M3 - Article

C2 - 24812045

AN - SCOPUS:84907446851

VL - 20

SP - 1304

EP - 1305

JO - Multiple Sclerosis

JF - Multiple Sclerosis

SN - 1352-4585

IS - 10

ER -