Abstract Details

Title Therapeutic Decision after JC Virus Testing in a Cohort of Patient Treated with Natalizumab

Topic MS and Related Diseases

Presentation(s) P01 - (-)

Poster/Presentation
Number 184

Objective

Background BACKGROUND: Since March 2011, a relevant JC antibodies diagnostic test is available for clinical practice. However, there is no clear guidelines concerning the best option in case of positive serology.

Design/Methods DESIGN/METHODS: Since April 2007, when marketing of natalizumab began in France, 378 multiple sclerosis patients have taken this treatment in our region. Among them, 292 patients consisting of 211 women and 81 men aged between 40.2 more or less 10.1 years, were still being treated when the testing of anti-JCV became available (April 2011). All patient were tested by the same laboratory (Unilabs) with two step enzyme linked immunosorbent assay. After results anouncement, we reported systematically which decision was taken by patients and neurologists.

Results RESULTS: Among the 292 patients, the anti-JCV test was found positive in 150 patients (51%). Hundred and two of the 150 patients received more than 2 years of treatment. Among these 150 patients, 38 (25.3 %) decide to modify the treatment. Fifteen of these 38 patients received an immunosuppressive drug before natalizumab therapy. The therapeutic alternative was first Gilenya (42%), therapeutic abstention (42%), Copaxone (11%) and Rebif (5%).

Conclusions CONCLUSIONS: In most cases, patients were very satisfied with their natalizumab treatment and expressed their desire to continue the treatment, even in patients (n = 23; 15%) with two risk factors (duration and JCV positive), for progressive multifocal leucoencephalopathy. A regular monitoring and evaluation including MRI every 6 months due to possible conversion seems necessary in these patients. In negative patients for JCV a one-year control of serology seems also necessary, as about 1-2% of patients may convert to positive serology.

Authors/Disclosures
PRESENTER	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file

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