Natalizumab-related progressive multifocal leukoencephalopathy in Greece

Related Experiment Video

Updated: Apr 14, 2026

Visualizing Impairment of the Endothelial and Glial Barriers of the Neurovascular Unit during Experimental Autoimmune Encephalomyelitis In Vivo
10:50

Visualizing Impairment of the Endothelial and Glial Barriers of the Neurovascular Unit during Experimental Autoimmune Encephalomyelitis In Vivo

Published on: March 26, 2019

8.4K

Dimos D Mitsikostas1, Vasileios Mastorodemos2, Minas Tsagournizakis2

  • 1Neurology Department, Athens Naval Hospital, 40 Deinokratous Street, 77A Vasilissis Sofias Avenue, 11521 Athens, Greece.

Multiple Sclerosis and Related Disorders
|April 17, 2015
PubMed
Abstract

Insights

Progressive multifocal leukoencephalopathy (PML) can occur during natalizumab treatment for multiple sclerosis. This study characterized Greek cases, finding varied outcomes and emphasizing the need for vigilant monitoring and early intervention in natalizumab-related PML.

Area of Science:

  • Neuroimmunology
  • Neurology
  • Infectious Diseases

Background:

  • Natalizumab is a disease-modifying therapy for multiple sclerosis.
  • Progressive multifocal leukoencephalopathy (PML) is a rare but serious adverse event associated with natalizumab.
  • Characterizing natalizumab-related PML (NR-PML) is crucial for patient management.

Purpose of the Study:

  • To describe the clinical and laboratory features of NR-PML cases in Greece.
  • To analyze treatment strategies and outcomes for NR-PML.

Main Methods:

  • Retrospective data collection from Greek neurology departments, pharmaceutical industry, and national drug authorities.
  • Classification of NR-PML cases using a five-level diagnostic certainty system.
  • Analysis of treatment regimens including plasma exchange, mirtazapine, mefloquine, and corticosteroids.

Main Results:

  • Thirteen NR-PML cases were identified, with data available for 9 patients.
  • PML onset occurred after a median of 40 natalizumab infusions.
  • Immune reconstitution inflammatory syndrome (IRIS) developed in 6 cases; 3 cases were fatal, and surviving patients had a median EDSS of 4.75 after 12 months.

Conclusions:

  • Outcomes for NR-PML patients in Greece ranged from death to recovery.
  • Early diagnosis and prompt treatment are critical for improving outcomes in NR-PML.
  • Close patient surveillance is essential during natalizumab therapy.
Keywords:
Adverse eventsImmune reconstitution inflammatory syndromeMultiple sclerosisNatalizumabProgressive multifocal leukoencephalopathyTreatment

More Related Videos

Induction of Paralysis and Visual System Injury in Mice by T Cells Specific for Neuromyelitis Optica Autoantigen Aquaporin-409:29

Induction of Paralysis and Visual System Injury in Mice by T Cells Specific for Neuromyelitis Optica Autoantigen Aquaporin-4

Published on: August 21, 2017

12.1K
High-throughput Flow Cytometry Cell-based Assay to Detect Antibodies to N-Methyl-D-aspartate Receptor or Dopamine-2 Receptor in Human Serum10:19

High-throughput Flow Cytometry Cell-based Assay to Detect Antibodies to N-Methyl-D-aspartate Receptor or Dopamine-2 Receptor in Human Serum

Published on: November 23, 2013

16.9K

Related Concept Videos

Antiepileptic Drugs: Potassium Channel Activators01:20

Antiepileptic Drugs: Potassium Channel Activators

Ezocgabine or retigabine, an antiepileptic drug of remarkable efficacy, has revolutionized the management of seizures. It is a potassium channel activator, explicitly targeting the family of Q subtype potassium channels. It enhances the transmembrane potassium currents, regulating neuronal excitability. This action stabilizes the resting membrane potential, a pivotal factor in mitigating the hyperexcitability that characterizes epilepsy.
Ezogabine has gained approval as an adjunctive treatment...
1.0K
Arboviral Encephalitis01:25

Arboviral Encephalitis

Arboviral encephalitis refers to brain inflammation caused by arthropod-borne viruses, particularly those transmitted through mosquito vectors. Among these, West Nile virus (WNV), a member of the Flaviviridae family, is a significant public health concern. WNV is an enveloped, positive-sense, single-stranded RNA virus. Human infection typically begins when an infected mosquito introduces the virus into the dermis during feeding. The primary transmission cycle involves birds as amplifying hosts...
43
Antiepileptic Drugs: Glutamate Antagonists01:14

Antiepileptic Drugs: Glutamate Antagonists

Glutamate is a fundamental neurotransmitter in the central nervous system, playing a vital role in neuronal communication and various cognitive processes. Glutamate stands as the principal excitatory neurotransmitter in the brain. Its presence is crucial for the communication between neurons, underpinning essential processes such as synaptic transmission, neuronal excitability, and plasticity. These functions are vital for higher-order cognitive processes, including learning and memory. The...
1.3K