van Lierop Zygj, Toorop A A, Coerver Eme, Willemse Eaj, Strijbis Emm, Kalkers N F, Moraal B, Barkhof F, Teunissen C E, Killestein J, van Kempen Zle
Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands.
Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam UMC, location VUmc, Amsterdam, the Netherlands.
Mult Scler J Exp Transl Clin. 2021 Jun 1;7(2):20552173211013831. doi: 10.1177/20552173211013831. eCollection 2021 Apr-Jun.
Ocrelizumab is often used as an alternative therapy in natalizumab-treated MS patients at risk for progressive multifocal leukoencephalopathy (PML). Our objective was to assess efficacy and safety of JC-virus positive patients switching (either directly or indirectly) from natalizumab to ocrelizumab. Forty-two patients were included from an observational cohort (median follow-up 21 months). No evidence of disease activity was found in 83% of direct switchers and 50% of indirect switchers. Two direct switchers were diagnosed with carry-over PML. Our data support a direct switch for adequate disease suppression, although carry-over PML illustrates the dilemma when choosing between a direct or indirect switch.
奥瑞珠单抗常用于对进行性多灶性白质脑病（PML）有风险的那他珠单抗治疗的多发性硬化症（MS）患者的替代治疗。我们的目的是评估从那他珠单抗直接或间接转换为奥瑞珠单抗的JC病毒阳性患者的疗效和安全性。从一个观察性队列中纳入了42例患者（中位随访21个月）。83%的直接转换者和50%的间接转换者未发现疾病活动的证据。两名直接转换者被诊断为遗留性PML。我们的数据支持直接转换以充分抑制疾病，尽管遗留性PML说明了在直接或间接转换之间做出选择时的困境。
