Journal of Neurology

, Volume 258, Issue 11, pp 1920–1928 | Cite as

Progressive multifocal leukoencephalopathy and natalizumab



Natalizumab (TYSABRI®), a specific α4-integrin antagonist, is approved as a second-line treatment of relapsing-remitting MS (RRMS) patients who fail therapy with interferons or as first-line treatment of patients with highly active relapsing-remitting disease. Since the market introduction of natalizumab as a monotherapy in July of 2006, 111 cases of PML have been reported in natalizumab-treated MS patients as of April 2011. This review focuses on the available data regarding risk stratification for PML under long-term natalizumab therapy, and summarizes the current approach for PML management, as a natalizumab treatment complication is not necessarily associated with a fatal outcome. There is a need for development of surrogate markers that would help to better define the risk of PML in individual patients.


Natalizumab IRIS Multiple sclerosis Plasmapheresis 



We thank Prof L. Kappos, Basel, for helpful discussions and comments. We thank Dr. Alexandra Schröder and Dr. Carsten Lukas for providing the MRI images.

Conflict of interest

RG and KH have received speaker’s and board honoraria, and grant support from BiogenIdec.


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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  1. 1.Department of Neurology, St. Josef HospitalRuhr University BochumBochumGermany

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