Natalizumab-PML survivors with subsequent MS treatment: Clinico-radiologic outcome. Issue 3 (May 2017)

• Record Type: Journal Article
• Authors: Maillart, Elisabeth; Vidal, Jean-Sebastien; Brassat, David; Stankoff, Bruno; Fromont, Agnès; de Sèze, Jérôme; Taithe, Frédéric; Clavelou, Pierre; Bourre, Bertrand; Delvaux, Valérie; Rico, Audrey; Labauge, Pierre; Tourbah, Ayman; Lebrun, Christine; Pelletier, Jean; Moreau, Thibault; Louapre, Céline; Lubetzki, Catherine; Papeix, Caroline
• Is Part Of: Neurology. Volume 4:Issue 3(2017)
• Publication Date: 2017-05
• Subjects: Neuroimmunology -- Periodicals; Neurology -- Periodicals; 616.8
• DOI: 10.1212/NXI.0000000000000346
• Languages: English
• ISSNs: 2332-7812

Abstract

Abstract : Objective: To describe the clinico-radiologic outcome of MS patients with natalizumab-related progressive multifocal leukoencephalopathy (Nz-PML) surviving and receiving disease-modifying therapy (DMT). Methods: We describe clinical and radiologic evolution of Nz-PML survivors in an observational retrospective multicenter cohort to clarify the effect of different subsequent MS DMT strategies. Twenty-three patients from 11 centers were analyzed. Outcomes were (1) clinical efficacy of post-PML MS DMT, (2) radiologic efficacy of post-PML MS DMT, (3) radiologic evolution of PML lesion, and (4) disability progression. Results: There was no clinical worsening of PML symptoms with a stability of Expanded Disability Status Scale at the last follow-up. No relapse was reported with fingolimod and dimethyl fumarate. No radiologic worsening of Nz-PML lesion was observed at the end of the follow-up. Conclusion: In this large cohort of patients with Nz-PML, MS therapies given after Nz discontinuation were not associated with PML worsening. A larger cohort with longer follow-up will be necessary to confirm this therapeutic strategy.