Prise en charge du risque de leuco-encéphalopathie multifocale progressive chez des patients atteints de sclérose en plaques traités par natalizumab : étude descriptive interrégionale Caen-Rouen

Abstract : Natalizumab (Natalizumab) is a monoclonal antibody directed against α-4 integrines approved for highly active relapsing-remitting multiple scleroses (MS). Despite demonstrated efficiency on disease course, Natalizumab is unfortunately associated with a risk of developing progressive multifocal leukoencephalopathy (PML) that led to restriction use depending of PML risk stratification established from 3 factors: Jhon Cunningham virus (JCV) seropositive status, prior immune therapy and treatment exposure duration (over two years). The objective was to study the impact of JCV seropositivity in Natalizumab-RR-MS treated patients. Natalizumab discontinuation decision-making was compared to individual risk of PML defined by its stratification.MS patients from two French MS centers, whose JCV serological status was known and Natalizumab treatment duration was six months minimum were included between October 2011 and December 2013. All the patients with a seronegative JCV status continued Natalizumab treatment at the end of the study. In total 19.83% (44/121) of Natalizumab treated patients for at least 6 months discontinuated the treatment. The main reported reason of Natalizumab discontinuation was PML risk for 55% (24/44). This observational study found a correlation between the PML risk and the rate of Natalizumab discontinuation. JCV seropositivity had a real impact on decision to carry on with Natalizumab treatment. PML risk stratification is a tool using in “real-life” by physician to discuss Natalizumab continuation in each patient. The development of antiJCV antibody index may allowed physicians to refine this decision.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02115769
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Submitted on : Tuesday, April 30, 2019 - 2:45:08 PM
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Floriane Calocer. Prise en charge du risque de leuco-encéphalopathie multifocale progressive chez des patients atteints de sclérose en plaques traités par natalizumab : étude descriptive interrégionale Caen-Rouen. Sciences pharmaceutiques. 2018. ⟨dumas-02115769⟩

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