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Anti-JC virus antibodies in rituximab-treated patients with neuromyelitis optica spectrum disorder

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Abstract

Rituximab, a chimeric monoclonal anti-CD20 antibody, has been proposed to be effective for neuromyelitis optica spectrum disorder (NMOSD). A concern for developing progressive multifocal leukoencephalopathy (PML), which is caused by John Cunningham virus (JCV), has been suggested particularly in patients treated long term with rituximab. In this study, using a modified enzyme-linked immunosorbent assay with glutathione S-transferase-tagged VP1 as the antigen, we investigated the seroprevalence of anti-JCV antibodies among 78 Korean patients with NMOSD and the change in anti-JCV antibody serostatus following long-term rituximab treatment. The overall seroprevalence of anti-JCV antibodies was 69 % prior to rituximab administration. Over a mean of 4 years of repeated treatment with rituximab, no patient developed PML. Of 24 initially seronegative patients, none converted into seropositive, whereas six (11 %) of 54 initially seropositive patients converted into seronegative. Our results might support the safety of long-term rituximab treatment in patients with NMOSD with regard to the risk of developing PML.

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Acknowledgments

The author(s) received no specific funding for this work.

Conflicts of interest

Kim SH, Hyun JW, Jeong IH, Joung AR, Yeon JL and Adams O report no conflict of interest. Dehmel T has received compensation for travel expenses from Novartis Pharma and Genzyme. Kieseier BC has received honoraria for lecturing, travel expenses for attending meetings, and financial support for research from Bayer Health Care, Biogen Idec, Genzyme/Sanofi Aventis, Grifols, Merck Serono, Mitsubishi Europe, Novartis, Roche, Talecris, and Teva. Kim HJ has received honoraria for speaking or consulting from Bayer Schering Pharma, Biogen Idec, Genzyme, Merck Serono, Novartis, MedImmune, and Teva-Handok and has received research grants from Genzyme, Merck Serono, and Kael-GemVax.

Ethical standard

This study was approved by the Institutional Review Board of the National Cancer Center, and informed consent was obtained from all patients.

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Authors and Affiliations

  1. Department of Neurology, Research Institute and Hospital of National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, Korea

    Su-Hyun Kim, Jae-Won Hyun, In Hye Jeong, AeRan Joung, Joung-Lim Yeon & Ho Jin Kim

  2. Department of Neurology, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany

    Thomas Dehmel & Bernd C. Kieseier

  3. Institute for Virology, Heinrich-Heine-University, Düsseldorf, Germany

    Ortwin Adams

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  1. Su-Hyun Kim
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  2. Jae-Won Hyun
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  4. AeRan Joung
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  5. Joung-Lim Yeon
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  6. Thomas Dehmel
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  7. Ortwin Adams
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  8. Bernd C. Kieseier
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  9. Ho Jin Kim
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Correspondence to Ho Jin Kim.

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Kim, SH., Hyun, JW., Jeong, I.H. et al. Anti-JC virus antibodies in rituximab-treated patients with neuromyelitis optica spectrum disorder. J Neurol 262, 696–700 (2015). https://doi.org/10.1007/s00415-014-7629-8

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  • DOI: https://doi.org/10.1007/s00415-014-7629-8

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