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Abstract Details

Disease Course and Outcome of 15 Monocentrically Treated Natalizumab-Associated Progressive Multifocal Leukoencephalopathy (PML) Patients
MS and Related Diseases
P01 - (-)
168
BACKGROUND: Little is known about the functional outcome of natalizumab-associated PML patients. Also it is not evident, to which extent MS disease activity resumes when natalizumab was stopped after onset of PML.
DESIGN/METHODS: The patients had a median natalizumab exposure of 34 months at PML diagnosis. They received standardized treatment as described in Wenning NEJM 2009. Sequential CSF analyses for JCV-DNA were performed at the Institute for Virology, University Duesseldorf. EDSS and Karnofsky Score in the year pre-PML, at PML-diagnosis and post-PML.
RESULTS: The mean follow up time of the patients was 19.2 months. None of them died. 3 patients had a Karnofsky Score greater than 70, 10 patients between 50-70 and 2 patients 40 or lower. The median EDSS in the year pre-PML was 2.5, 4.5 at PML diagnosis, 6.5 post-IRIS and 5.5 at the latest examination. CSF became virus-free in 9 of the 15 patients after a median time of 4 months. In 6 patients disease activity reappeared after a median time of 13.5 months from PML diagnosis. 7 patients received glatirameracetate, 1 patient interferon [szlig]-1a and 2 had to be escalated to fingolimod. 5 patients were stable without continuous immunotherapy.
CONCLUSIONS: Although the clinical outcome of natalizumab-treated PML patients is much better than in HIV-associated PML-patients, this may be further improved by treatment at reference centers using standardized therapy regimens. Systematic studies of follow-up immunotherapies after MS-PML are critically needed.
Authors/Disclosures

PRESENTER 		No disclosure on file
Robert Hoepner Robert Hoepner has nothing to disclose.
Andrew H. Chan, MD (Dept of Neurology, University of Bochum, St. Josef-Hospital) No disclosure on file
Ingo Kleiter (Neurologische Universitaetsklinik Regensburg) No disclosure on file
Satish Medicetty, PhD (Renovo Neural, Inc.) No disclosure on file
No disclosure on file
No disclosure on file
Kerstin Hellwig (St. Josef Hospital Bochum) Kerstin Hellwig has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Teva . Kerstin Hellwig has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BMS. Kerstin Hellwig has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis . Kerstin Hellwig has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Roche . Kerstin Hellwig has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck . Kerstin Hellwig has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sanofi Genzyme . Kerstin Hellwig has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Mylan . Kerstin Hellwig has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis . Kerstin Hellwig has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche . Kerstin Hellwig has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Merck . Kerstin Hellwig has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Novartis . Kerstin Hellwig has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Roche . The institution of Kerstin Hellwig has received research support from Roche . The institution of Kerstin Hellwig has received research support from Merck . The institution of Kerstin Hellwig has received research support from Biogen. The institution of Kerstin Hellwig has received research support from Genzyme . The institution of Kerstin Hellwig has received research support from Novartis . The institution of Kerstin Hellwig has received research support from BMS .
Ralf Gold, MD (Neurologische Universitaetsklinik) Dr. Gold has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biogen . Dr. Gold has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis. Dr. Gold has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Roche. Dr. Gold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genzyme. Dr. Gold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bayer Vital. Dr. Gold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eisai Pharamaceuticals. Dr. Gold has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Gold has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Gold has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for SAGE Publishers. Dr. Gold has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Novartis. Dr. Gold has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Biogen. The institution of Dr. Gold has received research support from Novartis. The institution of Dr. Gold has received research support from Biogen.
David H. Margolin, MD, PhD (Genzyme Corporation) Dr. Margolin has received personal compensation for serving as an employee of uniQure, Inc.. Dr. Margolin has stock in Cerevance, Inc. Dr. Margolin has stock in Datacubed Health. Dr. Margolin has stock in uniQure, Inc.. Dr. Margolin has received intellectual property interests from a discovery or technology relating to health care.