Key result
In MS patients on natalizumab, the 3-year risk of surpassing the 1.5 JCV antibody threshold was low for those testing negative (8.6%) or positive with titres ≤0.9 (12.5%) at baseline.
Why the study?
What is the risk of JCV seroconversion and passing the 1.5 antibody titre threshold in multiple sclerosis patients treated with natalizumab over 3 years?
Cohort (n=161)
No
What is the risk of JCV seroconversion and passing the 1.5 antibody titre threshold in multiple sclerosis patients treated with natalizumab over 3 years?
MS patients treated with natalizumab who are JCV-negative or have low positive titres (≤0.9) have a low risk of crossing the high-risk 1.5 threshold over 3 years.
Supports individualized JCV monitoring in low-titre natalizumab MS patients; leaves open prospective validation before practice change.
OBJECTIVES: Although many neurologists are reluctant to use natalizumab in MS (multiple sclerosis) given the increased risk for PML (progressive multifocal leukoencephalopathy), trust was regained with the introduction of JCV antibody titres as a potent disease-modifying therapy. Literature shows that in patients with a negative JCV serology, the risk of PML is virtually non-existent. Unfortunately, seroconversion causes concern amongst many neurologists. Furthermore, when patients seroconvert, it is still unclear what the risk is of passing the important threshold of 1.5. MATERIALS & METHODS: JCV serology data of 161 patients were analysed, upon treatment with natalizumab at the University Hospital in Lille, France, between May 2012 and November 2014. RESULTS: Of the 81 patients who tested negative for JCV antibody at baseline, 23 (28.3%) seroconverted but only seven (8.6%) passed the threshold of 1.5. Of the 80 patients testing positive for JCV antibody at baseline, eight had an initial JCV antibody titre of 0.9 or lower of which only one of eight (12.5%) patients passed the threshold of 1.5 in the following 3 years. Eight of 15 (53.3%) patients passed this threshold if the initial serology was higher than 0.9. CONCLUSIONS: JCV-negative patients and JCV-positive patients with antibody levels below or equal to 0.9 both have a low risk of surpassing the 1.5 threshold.
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Cambron et al. (2016) conducted a cohort in Multiple sclerosis (n=161). Baseline JCV antibody titre was evaluated on Passing the JCV antibody titre threshold of 1.5. In MS patients on natalizumab, the 3-year risk of surpassing the 1.5 JCV antibody threshold was low for those testing negative (8.6%) or positive with titres ≤0.9 (12.5%) at baseline.
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