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Progressive multifocal leukoencephalopathy

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https://www.readbyqxmd.com/read/28445498/metabolic-profiles-by-1h-magnetic-resonance-spectroscopy-in-natalizumab-associated-post-pml-lesions-of-multiple-sclerosis-patients-who-survived-progressive-multifocal-leukoencephalopathy-pml
#1
Ruth Schneider, Barbara Bellenberg, Robert Hoepner, Eva-Maria Kolb, Gisa Ellrichmann, Aiden Haghikia, Ralf Gold, Carsten Lukas
PURPOSE: Early diagnosis and treatment of multiple sclerosis-related progressive multifocal leukoencephalopathy (PML) significantly improve clinical outcomes. However, there is a lack of information regarding the restart of immunomodulatory therapy in the post-PML setting, when multiple sclerosis activity reappears. We aimed at the examination of metabolic differences using 1H-magnetic resonance spectroscopy (1H-MRS) in multiple sclerosis patients at various post-PML stages and at the exploration of differences according to their disease and JC virus (JCV) status...
2017: PloS One
https://www.readbyqxmd.com/read/28439420/an-unusual-cause-of-fatal-rapid-onset-ataxia-plus-syndrome
#2
Ivan Kmezic, Jan Weinberg, Dan Hauzenberger, Farouk Hashim, Evangelia Kollia, Monika Klimkowska, Inger Nennesmo, Martin Paucar
BACKGROUND: Progressive multifocal leukoencephalopathy (PML) is a demyelinating disorder of the central nervous system caused by reactivation of the JC-virus and is in most cases associated with underlying immunosuppression. Acquired immune deficiency syndrome (AIDS) and hematological malignancies are well-known predisposing factors for PML. However, in the past ten years, various pharmacological agents have been associated with increased risk of PML. Based on the phenomenology PML can be divided into the cerebral form and the rare cerebellar form...
2017: Cerebellum & Ataxias
https://www.readbyqxmd.com/read/28431609/benefit-risk-perception-of-natalizumab-therapy-in-neurologists-and-a-large-cohort-of-multiple-sclerosis-patients
#3
Christoph Heesen, Ingo Kleiter, Sven G Meuth, Julia Krämer, Jürgen Kasper, Sascha Köpke, Wolfgang Gaissmaier
BACKGROUND: Natalizumab (NAT) is associated with the risk of progressive multifocal leukoencephalopathy (PML). Risk stratification algorithms have been developed, however, without detectable reduction of PML incidence. OBJECTIVE: To evaluate to which extent patients and physicians understand and accept risks associated with NAT treatment. METHODS: Prospective observational cohort study in German MS centers (n=73) among NAT-treated MS patients (n=801) and their neurologists (n=99)...
May 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28428206/current-and-emerging-therapies-in-multiple-sclerosis-implications-for-the-radiologist-part-2-surveillance-for-treatment-complications-and-disease-progression
#4
REVIEW
C McNamara, G Sugrue, B Murray, P J MacMahon
An understanding of the new generation of MS drugs in conjunction with the key role MR imaging plays in the detection of disease progression, opportunistic infections, and drug-related adverse effects is of vital importance to the neuroradiologist. Part 1 of this review outlined the current treatment options available for MS and examined the mechanisms of action of the various medications. It also covered specific complications associated with each form of therapy. Part 2, in turn deals with the subject of pharmacovigilance and the optimal frequency of MRI monitoring for each individual patient, depending on his or her unique risk profile...
April 20, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28413713/catastrophic-outcome-of-patients-with-a-rebound-after-natalizumab-treatment-discontinuation
#5
Inés González-Suarez, Luis Rodríguez de Antonio, Aida Orviz, Sara Moreno-García, María D Valle-Arcos, Jordi A Matias-Guiu, Cristina Valencia, Manuela Jorquera Moya, Celia Oreja-Guevara
INTRODUCTION: Natalizumab (NTZ) is an effective drug for the treatment of relapsing-remitting multiple sclerosis. In some patients discontinuation is mandatory due to the risk of progressive multifocal leukoencephalopathy. However, severe clinical and radiological worsening has been described after drug cessation. Our aim was to describe the clinical and radiological features of the rebound phenomenon. MATERIAL AND METHODS: Patients switched from NTZ to Fingolimod (FTY) who had presented a rebound after discontinuation were selected...
April 2017: Brain and Behavior
https://www.readbyqxmd.com/read/28413313/additional-risk-minimisation-measures-for-medicinal-products-in-the-european-union-a-review-of-the-implementation-and-effectiveness-of-measures-in-the-united-kingdom-by-one-marketing-authorisation-holder
#6
Elaine Agyemang, Lorna Bailey, John Talbot
INTRODUCTION: Additional risk minimisation measures (aRMMs) for medicinal products are necessary to address specific important safety issues which may not be practically achieved through routine risk management measures alone. The implementation and determination of effectiveness for aRMMs can be a challenge as it involves multiple stakeholders. It is therefore important to have concise objectives to avoid undue burden on patients, healthcare professionals and the healthcare system. AIM: The aim of this study was to examine how aRMMs are implemented and how effectiveness is assessed in the European Union (EU) using practical examples from Roche Products Limited in the United Kingdom (UK) (referred to as the 'Company')...
2017: Pharmaceutical Medicine
https://www.readbyqxmd.com/read/28406921/is-the-risk-of-progressive-multifocal-leukoencephalopathy-the-real-reason-for-natalizumab-discontinuation-in-patients-with-multiple-sclerosis
#7
Julia Krämer, Jan-Gerd Tenberge, Ingo Kleiter, Wolfgang Gaissmaier, Tobias Ruck, Christoph Heesen, Sven G Meuth
BACKGROUND: Progressive multifocal leukoencephalopathy (PML) is one of the major risks of natalizumab therapy. Despite introduction of the currently employed PML risk stratification algorithm, the incidence of natalizumab-associated PML cases is not decreasing. OBJECTIVES: We addressed the following questions: How do natalizumab-treated multiple sclerosis patients and their treating physicians assess and deal with PML risk? Is PML risk the real reason for natalizumab discontinuation? METHODS: 699 natalizumab-treated multiple sclerosis patients and 99 physicians were included in this prospective observational study...
2017: PloS One
https://www.readbyqxmd.com/read/28378895/monitoring-cd49d-receptor-occupancy-a-method-to-optimize-and-personalize-natalizumab-therapy-in-multiple-sclerosis-patients
#8
Joan Puñet-Ortiz, José Vicente Hervás-García, Aina Teniente-Serra, Antonio Cano-Orgaz, Maria José Mansilla, Bibiana Quirant-Sánchez, Juan Navarro-Barriuso, Marco A Fernández-Sanmartín, Silvia Presas-Rodríguez, Cristina Ramo-Tello, Eva María Martínez-Cáceres
BACKGROUND: In natalizumab-treated relapsing-remitting MS (RRMS) patients, various extended interval dosing strategies are under evaluation to minimize severe treatment-associated side effects, mainly progressive multifocal leukoencephalopathy development. Up to now, it has not been presented any approach, even in form of assay design, to determine the optimal percentage of CD49d receptor occupancy (RO) associated with a favorable clinical, radiological, and immunological response. METHODS: A multiparametric quantitative flow cytometry method was settled to measure CD49d RO on peripheral blood lymphocytes...
April 5, 2017: Cytometry. Part B, Clinical Cytometry
https://www.readbyqxmd.com/read/28362268/progressive-multifocal-leukoencephalopathy-due-to-john-cunningham-jc-virus-following-allogeneic-hematopoietic-cell-transplantation
#9
Wilson Lam, Zeyad Al-Shaibani, Deepali Kumar, Auro Viswabandya, Santhosh Thyagu, Fotios V Michelis, Jeffrey H Lipton, Hans A Messner, Uday Deotare
Progressive multifocal leukoencephalopathy (PML) is an uncommon infectious complication post allogeneic stem cell transplant (allo-SCT). We present a case report of a patient developing this complication with a review of the current literature. It also describes the first use of artesunate in a clinical case of PML with no beneficial effect.
March 31, 2017: Antiviral Therapy
https://www.readbyqxmd.com/read/28348775/progressive-multifocal-leukoencephalopathy-and-black-fungus-in-a-patient-with-rheumatoid-arthritis-without-severe-lymphocytopenia
#10
Marieke J A de Regt, Jean-Luc Murk, Tilman Schneider-Hohendorf, Mike P Wattjes, Andy I M Hoepelman, Joop E Arends
INTRODUCTION: Progressive multifocal leukoencephalopathy (PML) is a rare demyelinating brain infection caused by JC polyomavirus (JCV), primarily seen in patients with severely compromised cellular immunity. Clinical presentation varies depending on the affected white matter. PML prognosis is variable and effective treatments are lacking. CASE PRESENTATION: A 75-year-old Chinese woman with type 2 diabetes mellitus, chronic kidney disease and rheumatoid arthritis, treated with low-dose methotrexate and prednisolone for 2...
August 2016: JMM Case Reports
https://www.readbyqxmd.com/read/28346586/human-immunodeficiency-virus-presenting-as-progressive-multifocal-leukoencephalopathy-restricted-to-the-posterior-fossa
#11
Ryan D Schubert, Megan B Richie
No abstract text is available yet for this article.
March 27, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28329650/increased-risk-of-opportunistic-infections-among-patients-with-moderate-to-severe-psoriasis-a-population-based-cohort-study-in-the-united-kingdom
#12
Junko Takeshita, Daniel B Shin, Alexis Ogdie, Joel M Gelfand
Infection is the second leading cause of death among psoriasis patients on phototherapy or systemic medications. The types of infections associated with psoriasis remain poorly understood. The aim of our study was to determine the risk of opportunistic infection (OI) among patients with psoriasis. We conducted a cohort study of patients with (N=199,700) and without (N=954,315) psoriasis in The Health Improvement Network electronic medical record database. Patients receiving phototherapy or systemic therapy were considered to have moderate-to-severe psoriasis (N=12,442)...
September 15, 2016: Dermatology Online Journal
https://www.readbyqxmd.com/read/28323224/progressive-multifocal-leukoencephalopathy-and-rheumatoid-arthritis-treatments
#13
Gaëlle Clavel, Antoine Moulignier, Luca Semerano
Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease of the central nervous system due to reactivation of the JC virus (JCV). PML is extremely uncommon despite the high prevalence of the virus in the general population. No specific treatment is available, and the prognosis is bleak. The diagnosis is based on brain imaging findings, detection of the JCV genome in cerebrospinal fluid samples and, in some cases, histological studies of the brain lesions. The pathophysiological mechanisms that drive the development of PML are incompletely understood...
March 16, 2017: Joint, Bone, Spine: Revue du Rhumatisme
https://www.readbyqxmd.com/read/28322482/progressive-multifocal-leukoencephalopathy-associated-with-fumaric-acid-esters-treatment-in-psoriasis-patients
#14
Deepak M W Balak, Enes Hajdarbegovic, Wichor M Bramer, Martino H A Neumann, H Bing Thio
BACKGROUND: Fumaric acid esters (FAEs) are a systemic treatment for psoriasis considered to have a favorable long-term safety profile without an increased risk for immunosuppression. However, progressive multifocal leukoencephalopathy (PML), a rare, opportunistic viral infection of the central nervous system, has been linked anecdotally to FAE treatment. OBJECTIVE: to assess clinical features and outcomes of FAE-associated PML cases. METHODS: Systematic literature search in multiple databases up to February, 25(th) 2016 for reports of PML in psoriasis patients treated with FAEs...
March 21, 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/28320193/good-outcome-of-brain-stem-progressive-multifocal-leukoencephalopathy-in-an-immunosuppressed-renal-transplant-patient-importance-of-early-detection-and-rapid-immune-reconstitution
#15
Roland Sauer, Philipp Gölitz, Johannes Jacobi, Stefan Schwab, Ralf A Linker, De-Hyung Lee
Progressive multifocal leukoencephalopathy (PML) is a rare, opportunistic and often fatal disease of the CNS which may occur under immunosuppression in transplant patients. Brain stem PML is associated with a particularly bad prognosis. Here, we present a case of a renal transplant patient treated with mycophenolate mofetil (MMF) and tacrolimus who developed brain stem PML with limb ataxia, dysarthria and dysphagia. Diagnosis was established by typical MRI features and detection of JCV-DNA in the CSF. Immune reconstitution after stopping MMF and tacrolimus led to a complete and sustained remission of symptoms with improvement of the brain stem lesion over a follow-up over 20months...
April 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28319193/stability-and-predictive-value-of-anti-jcv-antibody-index-in-multiple-sclerosis-a-6-year-longitudinal-study
#16
Harald Hegen, Michael Auer, Gabriel Bsteh, Franziska Di Pauli, Tatiana Plavina, Janette Walde, Florian Deisenhammer, Thomas Berger
BACKGROUND: Risk of natalizumab-related progressive multifocal leukoencephalopathy is associated with the presence of anti-JC-virus (JCV) antibodies. OBJECTIVE: To investigate the longitudinal evolution of anti-JCV antibody index and to determine the predictive value of baseline anti-JCV antibody index for long-term stability of anti-JCV antibody status. METHODS: MS patients from the MS centre of Medical University of Innsbruck, who had serum sampling for a time period of 4-6 years at intervals of 6±3 months, were included in this retrospective, longitudinal study...
2017: PloS One
https://www.readbyqxmd.com/read/28282574/long-term-effectiveness-and-safety-of-natalizumab-in-a-portuguese-population
#17
I Correia, S Batista, O Galego, I B Marques, J Jesus-Ribeiro, A I Martins, C Nunes, M C Macário, L Cunha, L Sousa
OBJECTIVES: Natalizumab long-term effectiveness data in real-world relapsing-remitting multiple sclerosis (RRMS) is needed. Our objective is to report the long-term effectiveness and safety of natalizumab in a cohort of RRMS patients. METHODS: This is a retrospective study of natalizumab treatment for two years or longer in RRMS. Annualized relapse rate, Expanded Disability Status Scale (EDSS), brain magnetic resonance imaging T2 lesion volume, JC virus antibody status, previous treatments and adverse events were analysed...
March 7, 2017: International Immunopharmacology
https://www.readbyqxmd.com/read/28278713/lenalidomide-associated-progressive-multifocal-leukoencephalopathy
#18
Francesco Brigo, Elisabetta Pagani, Frediano Tezzon, Elisa Masi, Raffaele Nardone
No abstract text is available yet for this article.
February 21, 2017: Leukemia & Lymphoma
https://www.readbyqxmd.com/read/28276855/the-safety-of-vedolizumab-for-the-treatment-of-ulcerative-colitis
#19
REVIEW
Gregor Novak, Pieter Hindryckx, Reena Khanna, Vipul Jairath, Brian G Feagan
Vedolizumab is a humanized monoclonal antibody to the α4β7-integrin that blocks lymphocyte trafficking to the gut and is approved for treatment of patients with moderate-to-severe ulcerative colitis (UC). The gut-selective mechanism of action has the potential to improve vedolizumab's safety profile compared to other approved biologic drugs. Areas covered: We review the mechanism of action, efficacy and safety of vedolizumab treatment for UC. The positioning of vedolizumab in management algorithms is also discussed...
April 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/28273765/comment-on-extensive-white-matter-lesions-after-2-years-of-fingolimod-progressive-multifocal-leukoencephalopathy-or-ms-relapse
#20
María Inés Gaitán, Jorge Correale
No abstract text is available yet for this article.
April 2017: Multiple Sclerosis: Clinical and Laboratory Research
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