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Safety, anxiety and natalizumab continuation in JC virus-seropositive MS patients

Johannis A van Rossum1, Anke Vennegoor, Lisanne Balk

  • 1Department of Neurology (MS Center Amsterdam), VU University Medical Center, The Netherlands.

Multiple Sclerosis (Houndmills, Basingstoke, England)
|July 6, 2013
PubMed

Insights

JC virus (JCV) positivity increases anxiety in multiple sclerosis patients on natalizumab but rarely impacts treatment continuation. Most patients remain on natalizumab despite JCV seropositivity, indicating manageable risk perception.

Area of Science:

  • Neuroimmunology
  • Viral Infections
  • Clinical Therapeutics

Background:

  • Natalalizumab is effective for multiple sclerosis (MS) but carries a risk of progressive multifocal leukoencephalopathy (PML).
  • JC virus (JCV) carriership is a primary risk factor for natalizumab-associated PML.
  • Limited data exist on how JCV serostatus influences patient decisions regarding natalizumab treatment.

Purpose of the Study:

  • To assess the impact of JCV seropositivity on patient anxiety and safety perceptions.
  • To evaluate the effect of JCV seropositivity on the willingness to continue natalizumab therapy.
  • To analyze decisional conflict related to natalizumab treatment in JCV-positive MS patients.

Main Methods:

  • Utilized visual analog scales for safety feelings.
  • Employed the Hospital Anxiety and Depression Scale (HADS) to measure anxiety.
  • Administered a decisional conflict scale to assess treatment continuation.
  • Correlated JCV serostatus with psychological and treatment adherence outcomes.

Main Results:

  • JCV seropositivity significantly elevated anxiety levels concerning PML risk (p = 0.004).
  • Despite increased anxiety, only 3% of patients in the cohort discontinued natalizumab due to JCV positivity.
  • No significant impact on overall treatment continuation was observed solely based on JCV positivity.

Conclusions:

  • JCV seropositivity is associated with heightened anxiety regarding PML in MS patients on natalizumab.
  • Natalalizumab treatment continuation is generally maintained by patients even when aware of JCV seropositivity.
  • Risk-benefit communication strategies may effectively manage patient concerns and support ongoing natalizumab therapy.
Keywords:
JC virusMultiple sclerosisnatalizumabprogressive multifocal leukoencephalopathy

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