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Serum anti-JCV antibody indexes in Japanese patients with multiple sclerosis: elevations along with fingolimod treatment duration

Abstract

Background

The risk of developing progressive multifocal leukoencephalopathy in natalizumab-treated multiple sclerosis (MS) patients is related to serum anti-JCV antibody (JCVAb) index. However, the correlation of JCVAb index with other disease-modifying treatments (DMTs) is not well understood.

Objective

In this study, we investigated the JCVAb seropositivity rate/JCVAb indexes and its correlation with clinical profiles in Japanese MS patients, and the relationship between JCVAb indexes and DMTs.

Methods

JCVAb indexes were measured in 149 serum samples from 105 patients with MS. JCVAb indexes and seropositivity, and their correlation with age, sex, disease duration, Kurtzke expanded disability status scale and the duration of the DMTs were evaluated in each patient.

Results

JCVAb was positive in 73 of 105 MS patients. Within 40 fingolimod-treated patients, 27 were positive for JCVAb and JCVAb indexes were positively correlated with the duration of fingolimod treatment. No significant relation was found between JCVAb indexes and the duration of treatment for the other disease-modifying drugs.

Conclusion

JCVAb seropositivity was comparatively high in Japanese MS patients. Fingolimod treatment is likely to increase serum JCVAb index, possibly leading to the development of PML. Therefore, it is advised that JCVAb index should be serially monitored during fingolimod treatment to decrease PML risk.

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Abbreviations

DMT:

Disease-modifying treatment

EDSS:

Kurtzke expanded disability status scale

JCV:

John Cunningham virus

MS:

Multiple sclerosis

PML:

Progressive multifocal leukoencephalopathy

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Acknowledgements

Part of this study was presented in a poster session at the 23rd WCN (World Congress of Neurology) held in Kyoto, Japan (September 2017).

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Correspondence to Masahiro Mori.

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Informed consent

All patients provided informed consent prior to their inclusion to this study.

Conflicts of interest

The authors declare no conflicts of interest.

Ethical standard statement

This study was approved by the Ethics Committee of Chiba University School of Medicine (No.842) and all participants provided written informed consent.

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Aoyama, S., Mori, M., Uzawa, A. et al. Serum anti-JCV antibody indexes in Japanese patients with multiple sclerosis: elevations along with fingolimod treatment duration. J Neurol 265, 1145–1150 (2018). https://doi.org/10.1007/s00415-018-8813-z

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  • DOI: https://doi.org/10.1007/s00415-018-8813-z

Keywords

  • Anti-JCV antibodies
  • Disease-modifying treatment
  • Fingolimod
  • Multiple sclerosis
  • Progressive multifocal leukoencephalopathy