Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
Department of Statistics, Faculty of Economics and Statistics, University of Innsbruck, Innsbruck, Austria.
Front Immunol. 2018 Oct 25;9:2435. doi: 10.3389/fimmu.2018.02435. eCollection 2018.
Risk of natalizumab-related progressive multifocal leukoencephalopathy is associated with the presence of anti-JC-virus (JCV) antibodies. To investigate the impact of disease-modifying treatments (DMT) on the longitudinal evolution of anti-JCV antibody index. Patients with multiple sclerosis who had serum sampling at intervals of 6 ± 3 months over up to 6 years and who either started DMT (interferon-β, glatiramer acetate or natalizumab) during the observation period with at least one serum sample available before and after treatment initiation or received no DMT during the observation period were included. Anti-JCV antibody serological status and index were determined by 2-step second-generation anti-JCV antibody assay. A total of 89 patients were followed for a median time of 55.2 months. Of those, 62 (69.7%) started DMT and 27 (30.3%) were without therapy during the observation period. Variation of longitudinal anti-JCV antibody index ranged from 9 to 15% and was similar in patients with and without DMT. Applying a mixed model considering the combined effects of treatment and time as well as individual heterogeneity did not show a significant change of anti-JCV antibody index by the start of treatment with interferon-β, glatiramer acetate, or natalizumab. Evaluated DMTs do not impact longitudinal anti-JCV antibody index evolution.
与抗 JC 病毒 (JCV) 抗体存在相关的那他珠单抗相关性进行性多灶性白质脑病风险。为了研究疾病修正治疗 (DMT) 对 JCV 抗体指数纵向演变的影响。在长达 6 年的时间内,每隔 6 ± 3 个月采集血清样本的多发性硬化症患者,在观察期间开始 DMT(干扰素-β、那他珠单抗或醋酸格拉替雷),且在治疗开始前和开始后至少有一次血清样本可用,或在观察期间未接受 DMT。通过两步第二代抗 JCV 抗体检测来确定 JCV 抗体血清学状态和指数。共有 89 例患者接受了中位时间为 55.2 个月的随访。其中,62 例(69.7%)开始 DMT,27 例(30.3%)在观察期间未接受治疗。纵向 JCV 抗体指数的变化范围为 9%至 15%,在接受和不接受 DMT 的患者中相似。应用混合模型考虑治疗和时间的综合效应以及个体异质性,未显示干扰素-β、醋酸格拉替雷或那他珠单抗治疗开始时 JCV 抗体指数有显著变化。评估的 DMT 不会影响纵向 JCV 抗体指数的演变。