Published in

Lippincott, Williams & Wilkins, Neurology: Neuroimmunology and Neuroinflammation, 1(8), p. e904, 2020

DOI: 10.1212/nxi.0000000000000904

Links

Tools

Export citation

Search in Google Scholar

Mild progressive multifocal leukoencephalopathy after switching from natalizumab to ocrelizumab

Journal article published in 2020 by Alyssa A. Toorop ORCID, Zoë Y. G. van Lierop ORCID, Eva E. M. Strijbis ORCID, Charlotte E. Teunissen ORCID, Axel Petzold ORCID, Mike P. Wattjes ORCID, Frederik Barkhof ORCID, Brigit A. de Jong, Zoé L. E. van Kempen ORCID, Joep Killestein ORCID
This paper is made freely available by the publisher.
This paper is made freely available by the publisher.

Full text: Download

Green circle
Preprint: archiving allowed
Upload
Green circle
Postprint: archiving allowed
Upload
Green circle
Published version: archiving allowed
Upload
Policy details
Data provided by SHERPA/RoMEO

Abstract

ObjectiveTo describe the disease course of carryover progressive multifocal leukoencephalopathy (PML) after switching from natalizumab to ocrelizumab in 2 patients with relapsing-remitting MS.MethodsTwo case reports with 1 year of follow-up and retrospective longitudinal measurements of serum neurofilament light (NfL) levels and B-cells.ResultsPML was diagnosed 78 days (case 1) and 97 days (case 2) after discontinuation of natalizumab. Both patients developed mild immune reconstitution inflammatory syndrome (IRIS) despite B-cell depletion caused by ocrelizumab. NfL levels increased in both patients during PML-IRIS. PML-IRIS lesions stabilized after treatment with mefloquine and mirtazapine, followed by methylprednisolone, and both patients continued therapy with ocrelizumab when B-cells started to repopulate.ConclusionsThe clinical course of carryover PML was mild in both patients, suggesting that B-cell depletion possibly did not aggravate PML-IRIS in these 2 patients.