Natalizumab and progressive multifocal leucoencephalopathy

• Published in: Annals of the rheumatic diseases Vol. 65; no. suppl 3; pp. iii48 - iii53
• Main Author: Berger, J R
• Format: Journal Article Conference Proceeding
• Language: English
• Published: London BMJ Publishing Group Ltd and European League Against Rheumatism 01.11.2006; BMJ; BMJ Publishing Group LTD; BMJ Group
• Subjects: Acquired immune deficiency syndrome; AIDS; AIDS-Related Opportunistic Infections - chemically induced; AIDS-Related Opportunistic Infections - therapy; Antibodies, Monoclonal - adverse effects; Antibodies, Monoclonal, Humanized; Biological and medical sciences; Bone marrow; central nervous system; cerebrospinal fluid; CNS; CSF; demyelination; Disease; HAART; highly active antiretroviral therapy; HIV; Human immunodeficiency virus; Humans; Immune system; Immunomodulators; JC virus; JCV; Leukoencephalopathy, Progressive Multifocal - chemically induced; Leukoencephalopathy, Progressive Multifocal - diagnosis; Leukoencephalopathy, Progressive Multifocal - therapy; Lymphocytes; Medical imaging; Medical sciences; monoclonal antibodies; Multiple sclerosis; Multiple Sclerosis, Relapsing-Remitting - drug therapy; Natalizumab; Nervous system; Opportunistic Infections - chemically induced; Opportunistic Infections - diagnosis; Opportunistic Infections - therapy; Patients; Pharmacology. Drug treatments; PML; Polymerase chain reaction; Prognosis; progressive multifocal leucoencephalopathy; Spleen; Tomography; Viral infections; Visual impairment; Immunomodulator; Progressive; Monoclonal antibody; Leucoencephalopathy; Natalizumab
• ISSN: 0003-4967; 1468-2060
• DOI: 10.1136/ard.2006.058404

Current data suggest that as many as 1 in 1000 treated individuals may develop progressive multifocal leucoencephalopathy (PML) in concert with the use of natalizumab. Natalizumab was withdrawn in early 2005. The present paper provides a comprehensive description of PML and reviews the role of natalizumab in the pathogenesis of PML. It is likely that use of drugs which cause specific perturbations of the immune system will be accompanied by similar rare infections. Thus researchers should be on the alert when using such agents in clinical trials.