Ocrelizumab after natalizumab in JC-virus positive relapsing remitting multiple sclerosis patients
Zoë YGJ van Lierop, Alyssa A Toorop, EME Coerver, Eaj Willemse, Eva Strijbis, NF Kalkers, Bastiaan Moraal, Frederik Barkhof, Charlotte E. Teunissen, Joep Killestein, ZLE van Kempen
Abstract
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.