Safety, anxiety and natalizumab continuation in JC virus-seropositive MS patients

The use of natalizumab in multiple sclerosis has been restricted by the risk of progressive multifocal leukoencephalopathy (PML). JC virus carriership, duration of natalizumab treatment and past immunosuppression are known risk factors. This has allowed for calculated risk assessment for individual...

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Bibliographic Details
Published in:Multiple sclerosis 2014-01, Vol.20 (1), p.108-111
Main Authors: van Rossum, Johannis A, Vennegoor, Anke, Balk, Lisanne, Uitdehaag, Bernard M, Polman, Chris H, Killestein, Joep
Format: Article
Language:English
Subjects:
Adult
Antibodies, Monoclonal, Humanized - therapeutic use
Anxiety
Anxiety - epidemiology
Anxiety - virology
Biological and medical sciences
Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases
Female
Human viral diseases
Humans
Infectious diseases
JC Virus
Leukoencephalopathy, Progressive Multifocal - virology
Male
Medical sciences
Multiple Sclerosis - drug therapy
Multiple Sclerosis - psychology
Multiple Sclerosis - virology
Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis
Natalizumab
Neurology
Polyomavirus Infections - complications
Risk Factors
Surveys and Questionnaires
Viral diseases
Viral diseases of the lymphoid tissue and the blood. Aids
Viral diseases of the nervous system
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Summary:The use of natalizumab in multiple sclerosis has been restricted by the risk of progressive multifocal leukoencephalopathy (PML). JC virus carriership, duration of natalizumab treatment and past immunosuppression are known risk factors. This has allowed for calculated risk assessment for individual patients to be implemented. Not much data are available about the effect of JCV carriership on patient willingness to continue natalizumab. Here, we evaluated the impact of JCV seropositivity on safety feelings, anxiety and treatment continuation for patients treated with natalizumab, using a visual analog scale, the Hospital Anxiety and Depression Scale and a decisional conflict scale. Seropositivity led to an elevated anxiety level for PML (p = 0.004). However, so far only 3% of patients have discontinued natalizumab because of JCV positivity in our cohort.
ISSN:1352-4585
1477-0970
DOI:10.1177/1352458513495582