A case report suggests a suppressed inflammatory response to central nervous system JC virus after a switch from natalizumab to teriflunomide.
Progressive multifocal leukoencephalopathy (PML) has been observed after switching from natalizumab to other agents. In a new report, Italian authors discuss the case of a woman with multiple sclerosis who changed to teriflunomide after being on natalizumab for 33 infusions, due to a positive JC virus (JCV) antibody index of 3.6.
MRI 2 months after the last natalizumab infusion was negative for PML. An untreated interval of 4 months separated the discontinuation of natalizumab and the start of teriflunomide. Eight months from her last infusion, and within 3 months of starting teriflunomide, MRI demonstrated a new nonenhancing lesion suspicious for PML. Cerebrospinal fluid (CSF) white cell count, protein, and glucose were normal, but JCV DNA …
Reviewing Author
DisclosuresConsultant/Advisory BoardAlexion Pharmaceuticals; Amgen; Astoria; Biogen; Bristol Myers Squibb; Celltrion; Genentech; Hoffmann-La Roche; Genzyme; EMD Serono; Immpact-Bio; Immunic Therapeutics; Kyverna; Lundbeck; Novartis; Sandoz; TG Therapeutics
Grant/Research SupportNational Institutes of Health; National Multiple Sclerosis Society; U.S. Department of Defense
Leadership Positions in Professional SocietiesConsortium of Multiple Sclerosis Centers (Treasurer)
DisclosuresConsultant/Advisory BoardAlexion Pharmaceuticals; Amgen; Astoria; Biogen; Bristol Myers Squibb; Celltrion; Genentech; Hoffmann-La Roche; Genzyme; EMD Serono; Immpact-Bio; Immunic Therapeutics; Kyverna; Lundbeck; Novartis; Sandoz; TG Therapeutics
Grant/Research SupportNational Institutes of Health; National Multiple Sclerosis Society; U.S. Department of Defense
Leadership Positions in Professional SocietiesConsortium of Multiple Sclerosis Centers (Treasurer)