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Natalizumab and progressive multifocal leucoencephalopathy
1Department of Neurology, University of Kentucky College of Medicine, Kentucky Clinic L-445, 740 S Limestone Street, Lexington, KY 40536-0284, USA. jrbneuro@uky.edu.
Annals of the Rheumatic Diseases
|October 14, 2006
Summary
Progressive multifocal leukoencephalopathy (PML) affects up to 1 in 1000 patients using natalizumab. Researchers must monitor for rare infections when using immune-altering drugs in clinical trials.
Area of Science:
- Neuroimmunology
- Infectious Diseases
Background:
- Progressive multifocal leukoencephalopathy (PML) is a rare, opportunistic infection of the central nervous system.
- Natalizumab, a monoclonal antibody, was associated with an increased risk of PML in treated individuals.
Purpose of the Study:
- To provide a comprehensive description of PML.
- To review the role of natalizumab in the pathogenesis of PML.
- To alert researchers to the potential for rare infections with immune-perturbing agents.
Main Methods:
- Literature review of PML cases associated with natalizumab.
- Analysis of the role of natalizumab in PML pathogenesis.
Main Results:
- Data indicate that up to 1 in 1000 individuals treated with natalizumab may develop PML.
- Natalizumab was withdrawn from the market in early 2005 due to safety concerns.
Conclusions:
- The use of natalizumab is linked to the development of PML.
- Similar rare infections may occur with other drugs causing specific immune system perturbations.
- Vigilance is required when using such agents in clinical trials to monitor for rare infections.
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