Natalizumab-Associated PML and IRIS

Immune reconstitution inflammatory syndrome developed in all multiple sclerosis patients with natalizumab-associated progressive multifocal leukoencephalopathy.

Natalizumab, a humanized monoclonal antibody targeting the α4-integrin receptor on leukocytes, is effective in the management of multiple sclerosis (MS) and Crohn disease. Uncommonly, through reactivation of the JC virus, it causes progressive multifocal leukoencephalopathy (PML). Patients with natalizumab-associated PML (NA-PML) have been managed with drug discontinuation and plasmapheresis or immunoadsorption (PLEX/IA), but a retrospective analysis of all 42 MedWatch reports on NA-PML in MS patients between November 2006 and March 2010 indicates that this approach is associated with neurological worsening caused by immune reconstitution inflammatory syndrome (IRIS).

The 42 patients involved all had signs of neurological deterioration devel…

Reviewing Author

Richard T. Ellison III, MD

Disclosures

Consult/Advisory BoardAcurx Pharmaceuticals, LLC;

Grant/Research SupportDoctors Company Foundation, Massachusetts Department of Public Health

Richard T. Ellison III, MD

Disclosures

Consult/Advisory BoardAcurx Pharmaceuticals, LLC;

Grant/Research SupportDoctors Company Foundation, Massachusetts Department of Public Health