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Determinants of outcomes for natalizumab-associated PML

Prof. Chris McGuigan, University College Dublin, Ireland

Natalizumab is an effective treatment for patients with active MS, but is associated with an increased risk of progressive multifocal leukoencephalopathy (PML) [1,2]. “We are concerned as clinicians about PML risk and how to manage it”, Prof. Chris McGuigan (University College Dublin, Ireland) stated.

Following a diagnosis of PML, various interventions, such as rapid natalizumab clearance by plasma exchange (PLEX), have been adopted in clinical practice [3,4]. PLEX is associated with increased clearance of natalizumab [5]. “However, the impact of PLEX on clinical outcomes was based on pharmacokinetic data and not on clinical evidence or real-world experience”, Prof. McGuigan added.

In the current analysis, the impact of PLEX and patient characteristics on the outcome of natalizumab-associated PML was investigated. Of the 787 confirmed natalizumab PML cases, 725 had a known PLEX status (PLEX-positive in 85.0%). A higher percentage of PLEX positive pa...

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