Abstract
Background: Risk of natalizumab-related progressive multifocal leukoencephalopathy is associated with the presence of anti-JC-virus (JCV) antibodies.Objective: To investigate the impact of disease-modifying treatments (DMT) on the longitudinal evolution of anti-JCV antibody index.Methods: Patients with multiple sclerosis who had serum sampling at intervals of 6 ± 3 months over up to 6 years and who either started DMT (interferon-β, glatiramer acetate or natalizumab) during the observation period with at least one serum sample available before and after treatment initiation or received no DMT during the observation period were included. Anti-JCV antibody serological status and index were determined by 2-step second-generation anti-JCV antibody assay.Results: A total of 89 patients were followed for a median time of 55.2 months. Of those, 62 (69.7%) started DMT and 27 (30.3%) were without therapy during the observation period. Variation of longitudinal anti-JCV antibody index ranged from 9 to 15% and was similar in patients with and without DMT. Applying a mixed model considering the combined effects of treatment and time as well as individual heterogeneity did not show a significant change of anti-JCV antibody index by the start of treatment with interferon-β, glatiramer acetate, or natalizumab.Conclusion: Evaluated DMTs do not impact longitudinal anti-JCV antibody index evolution.
Highlights
Natalizumab (NTZ) treatment in multiple sclerosis (MS) patients is associated with the risk of progressive multifocal leukoencephalopathy (PML), an opportunistic infection of the brain caused by John Cunningham virus (JCV) [1]
Previous studies evaluating the impact of DMT on anti-JCV antibodies yielded conflicting results, some of them claiming an increase of anti-JCV antibody index (AI) by NTZ treatment [6, 7]
We aimed to investigate the impact of different DMTs on anti-JCV AI evolution in a cohort of MS patients using— in contrast to earlier studies—a longitudinal study design with high frequency sampling over a long observation time and with several samples available before and after start of the respective treatment
Summary
Natalizumab (NTZ) treatment in multiple sclerosis (MS) patients is associated with the risk of progressive multifocal leukoencephalopathy (PML), an opportunistic infection of the brain caused by John Cunningham virus (JCV) [1]. Impact of DMTs on JCV Index patients, seroconversion might occur with a rate of approximately 2–6% per year [4, 5]. We aimed to investigate the impact of different DMTs on anti-JCV AI evolution in a cohort of MS patients using— in contrast to earlier studies—a longitudinal study design with high frequency sampling over a long observation time and with several samples available before and after start of the respective treatment. Risk of natalizumab-related progressive multifocal leukoencephalopathy is associated with the presence of anti-JC-virus (JCV) antibodies
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