Abstract
A total of 159 cases of progressive multifocal leukoencephalopathy (PML) have now been associated with natalizumab, an antibody that inhibits CNS lymphocyte entry by binding to α4 integrin.1 This study describes 2 of the 3 known fatal PML cases occurring following treatment with efalizumab, an adhesion molecule inhibitor that binds to the α subunit of LFA-1 (CD11a) and blocks its attachment to ICAM-1.2 The estimated risk of PML in patients treated with efalizumab (∼1:400) falls into the general range of that for natalizumab (∼1:600), and resulted in the removal of efalizumab from the market in 2009. A unique feature …
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