PML Risk Stratification in Multiple Sclerosis Patients on Natalizumab

Stratify risk of developing PML in patients with Multiple Sclerosis who are on natalizumab

Questions

1.Does the patient have positive JC virus antibody, using 2 step ELISA method?
2.Is there a prior history of immunosuppression?
3.Has the patient been on natalizumab for more than 2 years (24 infusions)?

About

Natalizumab is a monoclonal antibody that targets the a4 subunit of the a4b1 adhesion molecule with established clinical efficacy. It is infused monthly. The principal risk in use of natalizumab is that of development of Progressive Multifocal Encephalopathy (PML), a devastating brain parenchymal infection with no current treatment. Three main risk factors have been elucidated: JC virus antibody status, history of previous immunosuppression, and duration of natalizumab treatment (less than or greater than 2 years). If PML is suspected, the drug should be stopped.

References

Bloomgren G, Richman S, Hotermans C, Subramanyam M, Goelz S, Natarajan A, Lee S, Plavina T, Scanlon JV, Sandrock A, and Bozic C.

Risk of natalizumab-associated progressive multifocal leukoencephalopathy.

New England Journal of Medicine 2012 May 17, 366 (20): 1870-80

Created by on 20/06/2016

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1. Does the patient have positive JC virus antibody, using 2 step ELISA method?

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