Journal
MULTIPLE SCLEROSIS JOURNAL-EXPERIMENTAL TRANSLATIONAL AND CLINICAL
Volume 7, Issue 2, Pages -Publisher
SAGE PUBLICATIONS INC
DOI: 10.1177/20552173211013831
Keywords
Multiple sclerosis; natalizumab; ocrelizumab; JC virus; disease activity; progressive multifocal leukoencephalopathy
Categories
Funding
- Dutch MS Research Foundation [18-358f]
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The study showed that for JC-virus positive multiple sclerosis patients, switching from natalizumab to ocrelizumab, direct switchers had better outcomes, although there was a risk of carry-over PML.
Ocrelizumab is often used as an alternative therapy in natalizumab-treated MS patients at risk for progressive multifocal leukoencephalopathy (PML). Our objective was to assess efficacy and safety of JC-virus positive patients switching (either directly or indirectly) from natalizumab to ocrelizumab. Forty-two patients were included from an observational cohort (median follow-up 21 months). No evidence of disease activity was found in 83% of direct switchers and 50% of indirect switchers. Two direct switchers were diagnosed with carry-over PML. Our data support a direct switch for adequate disease suppression, although carry-over PML illustrates the dilemma when choosing between a direct or indirect switch.
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