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Natalizumab-PML survivors with subsequent MS treatment

Abstract : Objective: To describe the clinico-radiologic outcome of MS patients with natalizumab-related progressive multifocal leukoencephalopathy (Nz-PML) surviving and receiving disease-modifying therapy (DMT). Methods: We describe clinical and radiologic evolution of Nz-PML survivors in an observational retrospective multicenter cohort to clarify the effect of different subsequent MS DMT strategies. Twenty-three patients from 11 centers were analyzed. Outcomes were (1) clinical efficacy of post-PML MS DMT, (2) radiologic efficacy of post-PML MS DMT, (3) radiologic evolution of PML lesion, and (4) disability progression. Results: There was no clinical worsening of PML symptoms with a stability of Expanded Disability Status Scale at the last follow-up. No relapse was reported with fingolimod and dimethyl fumarate. No radiologic worsening of Nz-PML lesion was observed at the end of the follow-up. Conclusion: In this large cohort of patients with Nz-PML, MS therapies given after Nz discontinuation were not associated with PML worsening. A larger cohort with longer follow-up will be necessary to confirm this therapeutic strategy.
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Contributor : Jean-Philippe RANJEVA Connect in order to contact the contributor
Submitted on : Friday, January 21, 2022 - 2:56:00 PM
Last modification on : Wednesday, September 28, 2022 - 2:50:10 PM

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Elisabeth Maillart, Jean-Sebastien Vidal, David Brassat, Bruno Stankoff, Agnès Fromont, et al.. Natalizumab-PML survivors with subsequent MS treatment. Neurology Neuroimmunology & Neuroinflammation, 2017, 4 (3), pp.e346. ⟨10.1212/NXI.0000000000000346⟩. ⟨hal-03539165⟩



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