New Algorithms Improving PML Risk Stratification in MS Patients Treated With Natalizumab
Overview: We assessed the role of age and disease activity as new factors contributing to establish the risk of progressive multifocal leucoencephalopathy in multiple sclerosis patients treated with natalizumab in 36 University Hospitals in Europe. We performed the study in 1,307 multiple sclerosis...
| Autores: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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| Tipo de recurso: | artículo |
| Estado: | Versión publicada |
| Fecha de publicación: | 2020 |
| País: | España |
| Institución: | Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL) |
| Repositorio: | r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante |
| OAI Identifier: | oai:isabial.fundanetsuite.com:p6472 |
| Acceso en línea: | https://isabial.portalinvestigacion.com/publicaciones6472 |
| Access Level: | acceso abierto |
| Palabra clave: | multiple sclerosis demyelinating diseases biomarkers natalizumab progressive multifocal leucoencephalopathy disease modifying treatments |
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New Algorithms Improving PML Risk Stratification in MS Patients Treated With NatalizumabToboso, ITejeda-Velarde, AAlvarez-Lafuente, RArroyo, RHegen, HDeisenhammer, Fde la Maza, SSAlvarez-Cermeno, JCIzquierdo, GParamo, DOliva, PCasanova, BAguera-Morales, EFranciotta, DGastaldi, MFernandez, OUrbaneja, PGarcia-Dominguez, JMRomero, FLaroni, AUccelli, APerez-Sempere, ASaiz, ABlanco, YGalimberti, DScarpini, EEspejo, CMontalban, XRasche, LPaul, FGonzalez, IAlvarez, ERamo, CCaminero, ABAladro, YCalles, CEguia, PBelenguer-Benavides, ARamio-Torrenta, LQuintana, EMartinez-Rodriguez, JEOterino, Ade Silanes, CLCasanova, LILandete, LFrederiksen, JBsteh, GMulero, PComabella, MHernandez, MAEspino, MPrieto, JMPerez, DOtano, MPadilla, FGarcia-Merino, JANavarro, LMuriel, AFrossard, LCVillar, LMmultiple sclerosisdemyelinating diseasesbiomarkersnatalizumabprogressive multifocal leucoencephalopathydisease modifying treatmentsOverview: We assessed the role of age and disease activity as new factors contributing to establish the risk of progressive multifocal leucoencephalopathy in multiple sclerosis patients treated with natalizumab in 36 University Hospitals in Europe. We performed the study in 1,307 multiple sclerosis patients (70.8% anti-John Cunninghan virus positive antibodies) treated with natalizumab for a median time of 3.28 years. Epidemiological, clinical, and laboratory variables were collected. Lipid-specific IgM oligoclonal band status was available in 277 patients. Factors associated with progressive multifocal leucoencephalopathy onset were explored by uni- and multivariate logistic regression. Results: Thirty-five patients developed progressive multifocal leucoencephalopathy. The multivariate analysis identified anti-John Cunninghan virus antibody indices and relapse rate as the best predictors for the onset of this serious opportunistic infection in the whole cohort. They allowed to stratify progressive multifocal leucoencephalopathy risk before natalizumab initiation in individual patients [area under the curve (AUC) = 0.85]. The risk ranged from <1/3,300 in patients with anti-John Cunninghan virus antibody indices 0.5, to 1/50 in the opposite case. In patients with lipid-specific IgM oligoclonal bands assessment, age at natalizumab onset, anti-John Cunninghan virus antibody indices, and lipid-specific IgM oligoclonal band status predicted progressive multifocal leucoencephalopathy risk (AUC = 0.92). The absence of lipid-specific IgM oligoclonal bands was the best individual predictor (OR = 40.94). The individual risk ranged from <1/10,000 in patients younger than 45 years at natalizumab initiation, who showed anti John Cunningham virus antibody indices Conclusions: In a perspective of personalized medicine, disease activity, anti-lipid specific IgM oligoclonal bands, anti Jonh Cunninghan virus antibody levels, and age can help tailor natalizumab therapy in multiple sclerosis patients, as predictors of progressive multifocal leucoencephalopathy.FRONTIERS MEDIA SA2020info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://isabial.portalinvestigacion.com/publicaciones6472Frontiers in NeurologyISSN: 16642295reponame:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicanteinstname:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)Inglésinfo:eu-repo/semantics/openAccessoai:isabial.fundanetsuite.com:p64722026-06-12T10:20:37Z |
| dc.title.none.fl_str_mv |
New Algorithms Improving PML Risk Stratification in MS Patients Treated With Natalizumab |
| title |
New Algorithms Improving PML Risk Stratification in MS Patients Treated With Natalizumab |
| spellingShingle |
New Algorithms Improving PML Risk Stratification in MS Patients Treated With Natalizumab Toboso, I multiple sclerosis demyelinating diseases biomarkers natalizumab progressive multifocal leucoencephalopathy disease modifying treatments |
| title_short |
New Algorithms Improving PML Risk Stratification in MS Patients Treated With Natalizumab |
| title_full |
New Algorithms Improving PML Risk Stratification in MS Patients Treated With Natalizumab |
| title_fullStr |
New Algorithms Improving PML Risk Stratification in MS Patients Treated With Natalizumab |
| title_full_unstemmed |
New Algorithms Improving PML Risk Stratification in MS Patients Treated With Natalizumab |
| title_sort |
New Algorithms Improving PML Risk Stratification in MS Patients Treated With Natalizumab |
| dc.creator.none.fl_str_mv |
Toboso, I Tejeda-Velarde, A Alvarez-Lafuente, R Arroyo, R Hegen, H Deisenhammer, F de la Maza, SS Alvarez-Cermeno, JC Izquierdo, G Paramo, D Oliva, P Casanova, B Aguera-Morales, E Franciotta, D Gastaldi, M Fernandez, O Urbaneja, P Garcia-Dominguez, JM Romero, F Laroni, A Uccelli, A Perez-Sempere, A Saiz, A Blanco, Y Galimberti, D Scarpini, E Espejo, C Montalban, X Rasche, L Paul, F Gonzalez, I Alvarez, E Ramo, C Caminero, AB Aladro, Y Calles, C Eguia, P Belenguer-Benavides, A Ramio-Torrenta, L Quintana, E Martinez-Rodriguez, JE Oterino, A de Silanes, CL Casanova, LI Landete, L Frederiksen, J Bsteh, G Mulero, P Comabella, M Hernandez, MA Espino, M Prieto, JM Perez, D Otano, M Padilla, F Garcia-Merino, JA Navarro, L Muriel, A Frossard, LC Villar, LM |
| author |
Toboso, I |
| author_facet |
Toboso, I Tejeda-Velarde, A Alvarez-Lafuente, R Arroyo, R Hegen, H Deisenhammer, F de la Maza, SS Alvarez-Cermeno, JC Izquierdo, G Paramo, D Oliva, P Casanova, B Aguera-Morales, E Franciotta, D Gastaldi, M Fernandez, O Urbaneja, P Garcia-Dominguez, JM Romero, F Laroni, A Uccelli, A Perez-Sempere, A Saiz, A Blanco, Y Galimberti, D Scarpini, E Espejo, C Montalban, X Rasche, L Paul, F Gonzalez, I Alvarez, E Ramo, C Caminero, AB Aladro, Y Calles, C Eguia, P Belenguer-Benavides, A Ramio-Torrenta, L Quintana, E Martinez-Rodriguez, JE Oterino, A de Silanes, CL Casanova, LI Landete, L Frederiksen, J Bsteh, G Mulero, P Comabella, M Hernandez, MA Espino, M Prieto, JM Perez, D Otano, M Padilla, F Garcia-Merino, JA Navarro, L Muriel, A Frossard, LC Villar, LM |
| author_role |
author |
| author2 |
Tejeda-Velarde, A Alvarez-Lafuente, R Arroyo, R Hegen, H Deisenhammer, F de la Maza, SS Alvarez-Cermeno, JC Izquierdo, G Paramo, D Oliva, P Casanova, B Aguera-Morales, E Franciotta, D Gastaldi, M Fernandez, O Urbaneja, P Garcia-Dominguez, JM Romero, F Laroni, A Uccelli, A Perez-Sempere, A Saiz, A Blanco, Y Galimberti, D Scarpini, E Espejo, C Montalban, X Rasche, L Paul, F Gonzalez, I Alvarez, E Ramo, C Caminero, AB Aladro, Y Calles, C Eguia, P Belenguer-Benavides, A Ramio-Torrenta, L Quintana, E Martinez-Rodriguez, JE Oterino, A de Silanes, CL Casanova, LI Landete, L Frederiksen, J Bsteh, G Mulero, P Comabella, M Hernandez, MA Espino, M Prieto, JM Perez, D Otano, M Padilla, F Garcia-Merino, JA Navarro, L Muriel, A Frossard, LC Villar, LM |
| author2_role |
author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author |
| dc.subject.none.fl_str_mv |
multiple sclerosis demyelinating diseases biomarkers natalizumab progressive multifocal leucoencephalopathy disease modifying treatments |
| topic |
multiple sclerosis demyelinating diseases biomarkers natalizumab progressive multifocal leucoencephalopathy disease modifying treatments |
| description |
Overview: We assessed the role of age and disease activity as new factors contributing to establish the risk of progressive multifocal leucoencephalopathy in multiple sclerosis patients treated with natalizumab in 36 University Hospitals in Europe. We performed the study in 1,307 multiple sclerosis patients (70.8% anti-John Cunninghan virus positive antibodies) treated with natalizumab for a median time of 3.28 years. Epidemiological, clinical, and laboratory variables were collected. Lipid-specific IgM oligoclonal band status was available in 277 patients. Factors associated with progressive multifocal leucoencephalopathy onset were explored by uni- and multivariate logistic regression. Results: Thirty-five patients developed progressive multifocal leucoencephalopathy. The multivariate analysis identified anti-John Cunninghan virus antibody indices and relapse rate as the best predictors for the onset of this serious opportunistic infection in the whole cohort. They allowed to stratify progressive multifocal leucoencephalopathy risk before natalizumab initiation in individual patients [area under the curve (AUC) = 0.85]. The risk ranged from <1/3,300 in patients with anti-John Cunninghan virus antibody indices 0.5, to 1/50 in the opposite case. In patients with lipid-specific IgM oligoclonal bands assessment, age at natalizumab onset, anti-John Cunninghan virus antibody indices, and lipid-specific IgM oligoclonal band status predicted progressive multifocal leucoencephalopathy risk (AUC = 0.92). The absence of lipid-specific IgM oligoclonal bands was the best individual predictor (OR = 40.94). The individual risk ranged from <1/10,000 in patients younger than 45 years at natalizumab initiation, who showed anti John Cunningham virus antibody indices Conclusions: In a perspective of personalized medicine, disease activity, anti-lipid specific IgM oligoclonal bands, anti Jonh Cunninghan virus antibody levels, and age can help tailor natalizumab therapy in multiple sclerosis patients, as predictors of progressive multifocal leucoencephalopathy. |
| publishDate |
2020 |
| dc.date.none.fl_str_mv |
2020 |
| dc.type.none.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
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article |
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publishedVersion |
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https://isabial.portalinvestigacion.com/publicaciones6472 |
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https://isabial.portalinvestigacion.com/publicaciones6472 |
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Inglés |
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Inglés |
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info:eu-repo/semantics/openAccess |
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openAccess |
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FRONTIERS MEDIA SA |
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FRONTIERS MEDIA SA |
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Frontiers in Neurology ISSN: 16642295 reponame:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante instname:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL) |
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Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL) |
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r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante |
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r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante |
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