Progressive multifocal leukoencephalopathy and multiple sclerosis: lessons from natalizumab.

Current Neurology and Neuroscience Reports
Annette Langer-Gould, Lawrence Steinman

Abstract

Three patients have developed progressive multifocal leukoencephalopathy while being treated with natalizumab for their autoimmune diseases. One patient had relapsing-remitting multiple sclerosis (RRMS), one had Crohn's disease, and one (who had been enrolled in an RRMS phase III trial) had no evidence of multiple sclerosis on autopsy. The patient with RRMS now has severe, permanent neurologic damage and the other two patients died. In this article, we recommend revised entry and diagnostic criteria to prevent enrollment of RRMS patients with a favorable prognosis or questionable diagnosis into trials of drugs with unknown safety profiles. In light of the risk of progressive multifocal leukoencephalopathy, we strongly recommend that RRMS patients who are at low risk of disability not be treated with natalizumab. Finally, we discuss what additional natalizumab efficacy data need to be presented before any decisions should be made about treating RRMS patients with a high risk of developing long-term disability.

References

Apr 1, 1995·BMJ : British Medical Journal·C TzourioM G Bousser
Feb 1, 1993·Brain : a Journal of Neurology·B Runmarker, O Andersen
Jan 1, 1997·AJR. American Journal of Roentgenology·W C Black, H G Welch
Jan 18, 2002·The New England Journal of Medicine·Peter A BrexDavid H Miller
Jun 20, 2003·Multiple Sclerosis : Clinical and Laboratory Research·Maja ErikssonBjörn Runmarker
Oct 30, 2003·Multiple Sclerosis : Clinical and Laboratory Research·Anat AchironZeev Rotstein
Jan 30, 2004·JAMA : the Journal of the American Medical Association·Mark C KruitLenore J Launer
Apr 6, 2004·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·Dinesh KhannaDaniel E Furst
Jul 28, 2004·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·S M ArendJ T Van Dissel
Aug 5, 2004·Annals of Neurology·Sean J PittockMoses Rodriguez
Sep 15, 2004·Archives of Neurology·Roy W BeckUNKNOWN Optic Neuritis Study Group
Mar 22, 2005·Journal of Neurology·Petra NilssonMagnhild Sandberg-Wollheim
Jun 3, 2005·Nature·Marc Feldmann, Lawrence Steinman
Jun 3, 2005·Nature Reviews. Drug Discovery·Lawrence Steinman
Jun 11, 2005·The New England Journal of Medicine·Annette Langer-GouldDaniel Pelletier
Jun 11, 2005·The New England Journal of Medicine·B K Kleinschmidt-DeMasters, Kenneth L Tyler
Jun 11, 2005·The New England Journal of Medicine·Gert Van AsschePaul Rutgeerts
Jun 11, 2005·The New England Journal of Medicine·Jeffrey M Drazen
Jun 11, 2005·The New England Journal of Medicine·Joseph R Berger, Igor J Koralnik
Oct 21, 2005·The New England Journal of Medicine·Thomas Berger, Florian Deisenhammer

❮ Previous
Next ❯

Citations

Oct 15, 2009·Annual Review of Medicine·C Thomas Caskey
Jan 27, 2016·Expert Review of Gastroenterology & Hepatology·Dino TarabarDavid T Rubin
Jul 29, 2008·Neurologic Clinics·Thomas Weber
Sep 15, 2009·Journal of Controlled Release : Official Journal of the Controlled Release Society·Hong ZhaoElizabeth M Topp
Jun 10, 2009·Seminars in Cancer Biology·Melissa S Maginnis, Walter J Atwood
Oct 19, 2014·International Immunology·Nicholas SchwabHeinz Wiendl
Nov 29, 2016·Acta Neurologica Scandinavica·P Soelberg Sorensen

❮ Previous
Next ❯

Related Concepts

Related Feeds

Autoimmune Diseases

Autoimmune diseases occur as a result of an attack by the immune system on the body’s own tissues resulting in damage and dysfunction. There are different types of autoimmune diseases, in which there is a complex and unknown interaction between genetics and the environment. Discover the latest research on autoimmune diseases here.

Cell Migration

Cell migration is involved in a variety of physiological and pathological processes such as embryonic development, cancer metastasis, blood vessel formation and remoulding, tissue regeneration, immune surveillance and inflammation. Here is the latest research.

Related Papers

Lancet
Annette Langer-Gould, Lawrence Steinman
Expert Opinion on Pharmacotherapy
Sheila A Doggrell
Neuro-degenerative Diseases
Britta Engelhardt, L Kappos
Nature Biotechnology
Hannah Hoag
© 2022 Meta ULC. All rights reserved