Natalizumab: management of PML
Evidence-based neurology checklist on natalizumab: management of pml: Risk factors for PML on Natalizumab Previous immunosuppression Positive JC virus antibody Treatment for >2 years Increased serum neurofilament (NFL) at PML onset Risk reduction of PML on Natalizumab Magnetic resonance imaging…
Risk factors for PML on Natalizumab
- Previous immunosuppression
- Positive JC virus antibody
- Treatment for >2 years
- Increased serum neurofilament (NFL) at PML onset
Risk reduction of PML on Natalizumab
Magnetic resonance imaging (MRI)
Cerebrospinal fluid (CSF)
Monitoring for PML: JC virus antibody screening
Monitoring for PML: magnetic resonance imaging (MRI)
Monitoring for PML: neutralising antibodies: indications
Switching from Natalizumab: protocol
Switching from natalizumab: washout period
Treatment of PML
Acronym
Related checklists section
References
- Torkildsen Ø, Myhr KM, Bø L. Disease-modifying treatments for multiple sclerosis – a review of approved medications. Eur J Neurol 2016; 23(Suppl 1):18-27.
- Kappos L,Bates D, Edan G, et al. Natalizumab treatment for multiple sclerosis: updated recommendations for patient selection and monitoring. Lancet Neurol 2011; 10:745-758.
- Vargas DL, Tyor WR. Update on disease-modifying therapies for multiple sclerosis. J Investig Med 2017; 65:883-891.
- Dalla Costa G, Martinelli V, Moiola L, et al. Serum neurofilaments increase at progressive multifocal leukoencephalopathy onset in natalizumab-treated multiple sclerosis patients. Ann Neurol 2019; 85:606-610.
- Ryerson LZ, Foley J, Chang I, Kister I, et al. Risk of natalizumab-associated PML in patients with MS is reduced with extended interval dosing. Neurology 2019; 93:e1452-e1462.
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