Natalizumab and progressive multifocal leukoencephalopathy: What are the causal factors and can it be avoided?

Clemens Warnke, Til Menge, Hans Peter Hartung, Michael K. Racke, Petra D. Cravens, Jeffrey L. Bennett, Elliot Frohman, Benjamin Greenberg, Scott S. Zamvil, Ralf Gold, Bernhard Hemmer, Bernd C. Kieseier, Olaf Stuve

Research output: Contribution to journalReview article

95 Scopus citations

Abstract

Natalizumab (Tysabri) was the first monoclonal antibody approved for the treatment of relapsing forms of multiple sclerosis (MS). After its initial approval, 3 patients undergoing natalizumab therapy in combination with other immunoregulatory and immunosuppressive agents were diagnosed with progressive multifocal leukoencephalopathy (PML). The agent was later reapproved and its use restricted to monotherapy in patients with relapsing forms of MS. Since reapproval in 2006, additional cases of PML were reported in patients with MS receiving natalizumab monotherapy. Thus, there is currently no convincing evidence that natalizumab-associated PML is restricted to combination therapy with other disease-modifying or immunosuppressive agents. In addition, recent data indicate that risk of PML might increase beyond 24 months of treatment.

Original languageEnglish (US)
Pages (from-to)923-930
Number of pages8
JournalArchives of neurology
Volume67
Issue number8
DOIs
StatePublished - Aug 1 2010

ASJC Scopus subject areas

  • Arts and Humanities (miscellaneous)
  • Clinical Neurology

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    Warnke, C., Menge, T., Hartung, H. P., Racke, M. K., Cravens, P. D., Bennett, J. L., Frohman, E., Greenberg, B., Zamvil, S. S., Gold, R., Hemmer, B., Kieseier, B. C., & Stuve, O. (2010). Natalizumab and progressive multifocal leukoencephalopathy: What are the causal factors and can it be avoided? Archives of neurology, 67(8), 923-930. https://doi.org/10.1001/archneurol.2010.161