Treating MS after surviving PML: Discrete strategies for rescue, remission, and recovery patient 2: From the National Multiple Sclerosis Society Case Conference Proceedings.

Published on Jan 1, 2021in Neuroimmunology and Neuroinflammation7.724
· DOI :10.1212/NXI.0000000000000930
Roberto Alejandro Cruz4
Estimated H-index: 4
Nick Hogan1
Estimated H-index: 1
(University of Texas at Austin)
+ 15 AuthorsTeresa C. Frohman37
Estimated H-index: 37
The patient is a right-handed White woman with relapsing-remitting MS diagnosed subsequent to left acute optic neuritis (AON). She described a previous transient episode of severe, electrical, and paroxysmal facial pain consistent with trigeminal neuralgia. Initial MRI demonstrated supratentorial
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Objective To determine whether the punctuated administration of low-dose rituximab, temporally linked to B-cell hyperrepopulation (defined when the return of CD19+ B cells approximates 40%–50% of baseline levels as measured before alemtuzumab treatment inception), can mitigate alemtuzumab-associated secondary autoimmunity. Methods In this hypothesis-driven pilot study, 10 patients received low-dose rituximab (50–150 mg/m2), a chimeric anti-CD20 monoclonal antibody, after either their first or se...
#1Marinella Clerico (UNITO: University of Turin)H-Index: 23
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Extending the natalizumab interval after the 24th administration could reduce the risk of progressive multifocal leukoencephalopathy (PML). The objective is to evaluate the noninferiority of the efficacy of an extended interval dosing (EID) compared with the standard interval dosing (SID) of natalizumab. It is an observational, multicenter (14 Italian centers), retrospective cohort study, starting from the 24th natalizumab infusion to the loss of follow-up or 2 years after baseline. Patients wer...
#1Lana Zhovtis Ryerson (NYU: New York University)H-Index: 7
#2John Foley (NYU: New York University)H-Index: 6
Last. Nolan Campbell (NYU: New York University)H-Index: 1
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Objective To use the large dataset from the Tysabri Outreach: Unified Commitment to Health (TOUCH) program to compare progressive multifocal leukoencephalopathy (PML) risk with natalizumab extended interval dosing (EID) vs standard interval dosing (SID) in patients with multiple sclerosis (MS). Methods This retrospective cohort study included anti-JC virus antibody-positive patients (n = 35,521) in the TOUCH database as of June 1, 2017. The effect of EID on PML risk was evaluated with 3 planned ...
#1Johann SellnerH-Index: 29
#2Paulus S. Rommer (Medical University of Vienna)H-Index: 26
Abstract Natalizumab is an effective treatment for relapsing-remitting multiple sclerosis (RRMS), but treatment for >2 years is associated with an increased risk of opportunistic infection and progressive multifocal leukoencephalopathy (PML). For this reason, patients and physicians may consider discontinuing natalizumab therapy. This article reviews the evidence for the various therapeutic approaches that may be taken in such patients. Stopping therapy altogether is unlikely to be appropriate f...
Tumor necrosis factor–α (TNF-α) blockers are a popular therapeutic choice in a number of inflammatory diseases. Thus far, five TNF- α blockers have been approved for clinical use (etanercept, infliximab, adalimumab, golimumab. and certolizumab). Despite being considered relatively safe, serious side effects associated with immune suppression have been reported, including central and peripheral nervous system (CNS) demyelinating disorders. It is still elusive whether these events are mere coincid...
#1L. Zhovtis Ryerson (NYU: New York University)H-Index: 1
#2Teresa C. Frohman (UTSW: University of Texas Southwestern Medical Center)H-Index: 37
Last. Roberto Bomprezzi (UMMS: University of Massachusetts Medical School)H-Index: 15
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Background Natalizumab (NTZ), a monoclonal antibody to human α 4 β 1 /β 7 integrin, is an effective therapy for multiple sclerosis (MS), albeit associated with progressive multifocal leukoencephalopathy (PML). Clinicians have been extending the dose of infusions with a hypothesis of reducing PML risk. The aim of the study is to evaluate the clinical consequences of reducing NTZ frequency of infusion up to 8 weeks 5 days. Methods A retrospective chart review in 9 MS centres was performed in order...
#1Elliot M. Frohman (UTSW: University of Texas Southwestern Medical Center)H-Index: 84
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Ivacaftor, an oral potentiator of the cystic fibrosis transmembrane conductance regulator (CFTR) protein, has been shown to be efficacious in patients heterozygous for the G551D mutation in CFTR. This letter describes the effect of ivacaftor in a patient homozygous for this mutation.
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In the Neurology® Neuroimmunology & Neuroinflammation Article “Treating MS after surviving …
#1Nidhiben Anadani (UR: University of Rochester)
#2Megan HylandH-Index: 5
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A 38-year-old woman with MS receiving natalizumab presented to the neurology clinic with the complaint of a new neurologic symptom. ### Clinical course The patient had a 6-year history of clinically stable MS, albeit exhibiting radiographic progression despite strict adherence to daily
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