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: | Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO) |
| Repositorio: | r-FISABIO. Repositorio Institucional de Producción Científica |
| OAI Identifier: | oai:fisabio.fundanetsuite.com:p8697 |
| Acceso en línea: | https://fisabio.portalinvestigacion.com/publicaciones/8697 |
| 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 FSainz de la Maza SAlvarez-Cermeño JCIzquierdo GParamo DOliva PCasanova BAgüera-Morales EFranciotta DGastaldi MFernández OUrbaneja PGarcia-Dominguez JMRomero FLaroni AUccelli APerez-Sempere ASaiz ABlanco YGalimberti DScarpini EEspejo CMontalban XRasche LPaul FGonzález IÁlvarez ERamo CCaminero ABAladro YCalles CEguía PBelenguer-Benavides ARamió-Torrentà LQuintana EMartínez-Rodríguez JEOterino ALópez de Silanes CCasanova LILandete LFrederiksen JBsteh GMulero PComabella MHernández MAEspiño MPrieto JMPérez DOtano MPadilla FGarcía-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://fisabio.portalinvestigacion.com/publicaciones/8697Frontiers in NeurologyISSN: 16642295reponame:r-FISABIO. Repositorio Institucional de Producción Científicainstname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)Inglésinfo:eu-repo/semantics/openAccessoai:fisabio.fundanetsuite.com:p86972026-06-11T12:45:17Z |
| 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 Sainz de la Maza S Alvarez-Cermeño JC Izquierdo G Paramo D Oliva P Casanova B Agüera-Morales E Franciotta D Gastaldi M Fernández 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 González I Álvarez E Ramo C Caminero AB Aladro Y Calles C Eguía P Belenguer-Benavides A Ramió-Torrentà L Quintana E Martínez-Rodríguez JE Oterino A López de Silanes C Casanova LI Landete L Frederiksen J Bsteh G Mulero P Comabella M Hernández MA Espiño M Prieto JM Pérez D Otano M Padilla F García-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 Sainz de la Maza S Alvarez-Cermeño JC Izquierdo G Paramo D Oliva P Casanova B Agüera-Morales E Franciotta D Gastaldi M Fernández 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 González I Álvarez E Ramo C Caminero AB Aladro Y Calles C Eguía P Belenguer-Benavides A Ramió-Torrentà L Quintana E Martínez-Rodríguez JE Oterino A López de Silanes C Casanova LI Landete L Frederiksen J Bsteh G Mulero P Comabella M Hernández MA Espiño M Prieto JM Pérez D Otano M Padilla F García-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 Sainz de la Maza S Alvarez-Cermeño JC Izquierdo G Paramo D Oliva P Casanova B Agüera-Morales E Franciotta D Gastaldi M Fernández 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 González I Álvarez E Ramo C Caminero AB Aladro Y Calles C Eguía P Belenguer-Benavides A Ramió-Torrentà L Quintana E Martínez-Rodríguez JE Oterino A López de Silanes C Casanova LI Landete L Frederiksen J Bsteh G Mulero P Comabella M Hernández MA Espiño M Prieto JM Pérez D Otano M Padilla F García-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 |
| format |
article |
| status_str |
publishedVersion |
| dc.identifier.none.fl_str_mv |
https://fisabio.portalinvestigacion.com/publicaciones/8697 |
| url |
https://fisabio.portalinvestigacion.com/publicaciones/8697 |
| dc.language.none.fl_str_mv |
Inglés |
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Inglés |
| dc.rights.none.fl_str_mv |
info:eu-repo/semantics/openAccess |
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openAccess |
| dc.publisher.none.fl_str_mv |
FRONTIERS MEDIA SA |
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FRONTIERS MEDIA SA |
| dc.source.none.fl_str_mv |
Frontiers in Neurology ISSN: 16642295 reponame:r-FISABIO. Repositorio Institucional de Producción Científica instname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO) |
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Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO) |
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r-FISABIO. Repositorio Institucional de Producción Científica |
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r-FISABIO. Repositorio Institucional de Producción Científica |
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