Mild progressive multifocal leukoencephalopathy after switching from natalizumab to ocrelizumab

Alyssa A Toorop; Zoë Y G van Lierop; Eva E M Strijbis; Charlotte E Teunissen; Axel Petzold; Mike P Wattjes; Frederik Barkhof; Brigit A de Jong; Zoé L E van Kempen; Joep Killestein

doi:https://doi.org/10.1212/NXI.0000000000000904

Mild progressive multifocal leukoencephalopathy after switching from natalizumab to ocrelizumab

Alyssa A Toorop, Zoë Y G van Lierop, Eva E M Strijbis, Charlotte E Teunissen, Axel Petzold, Mike P Wattjes, Frederik Barkhof, Brigit A de Jong, Zoé L E van Kempen, Joep Killestein

Research output: Contribution to journal › Article › Academic › peer-review

18 Citations (Scopus)

Abstract

OBJECTIVE: To describe the disease course of carryover progressive multifocal leukoencephalopathy (PML) after switching from natalizumab to ocrelizumab in 2 patients with relapsing-remitting MS.

METHODS: Two case reports with 1 year of follow-up and retrospective longitudinal measurements of serum neurofilament light (NfL) levels and B-cells.

RESULTS: PML was diagnosed 78 days (case 1) and 97 days (case 2) after discontinuation of natalizumab. Both patients developed mild immune reconstitution inflammatory syndrome (IRIS) despite B-cell depletion caused by ocrelizumab. NfL levels increased in both patients during PML-IRIS. PML-IRIS lesions stabilized after treatment with mefloquine and mirtazapine, followed by methylprednisolone, and both patients continued therapy with ocrelizumab when B-cells started to repopulate.

CONCLUSIONS: The clinical course of carryover PML was mild in both patients, suggesting that B-cell depletion possibly did not aggravate PML-IRIS in these 2 patients.

Original language	English
Journal	Neurology neuroimmunology & neuroinflammation
Volume	8
Issue number	1
DOIs	https://doi.org/10.1212/NXI.0000000000000904
Publication status	Published - 1 Jan 2021

Access to Document

https://doi.org/10.1212/NXI.0000000000000904

Cite this

Toorop, A. A., van Lierop, Z. Y. G., Strijbis, E. E. M., Teunissen, C. E., Petzold, A., Wattjes, M. P., Barkhof, F., de Jong, B. A., van Kempen, Z. L. E., & Killestein, J. (2021). Mild progressive multifocal leukoencephalopathy after switching from natalizumab to ocrelizumab. Neurology neuroimmunology & neuroinflammation, 8(1). https://doi.org/10.1212/NXI.0000000000000904

@article{c03af205d779481ebf53c5469643dad8,

title = "Mild progressive multifocal leukoencephalopathy after switching from natalizumab to ocrelizumab",

abstract = "OBJECTIVE: To describe the disease course of carryover progressive multifocal leukoencephalopathy (PML) after switching from natalizumab to ocrelizumab in 2 patients with relapsing-remitting MS.METHODS: Two case reports with 1 year of follow-up and retrospective longitudinal measurements of serum neurofilament light (NfL) levels and B-cells.RESULTS: PML was diagnosed 78 days (case 1) and 97 days (case 2) after discontinuation of natalizumab. Both patients developed mild immune reconstitution inflammatory syndrome (IRIS) despite B-cell depletion caused by ocrelizumab. NfL levels increased in both patients during PML-IRIS. PML-IRIS lesions stabilized after treatment with mefloquine and mirtazapine, followed by methylprednisolone, and both patients continued therapy with ocrelizumab when B-cells started to repopulate.CONCLUSIONS: The clinical course of carryover PML was mild in both patients, suggesting that B-cell depletion possibly did not aggravate PML-IRIS in these 2 patients.",

author = "Toorop, {Alyssa A} and {van Lierop}, {Zo{\"e} Y G} and Strijbis, {Eva E M} and Teunissen, {Charlotte E} and Axel Petzold and Wattjes, {Mike P} and Frederik Barkhof and {de Jong}, {Brigit A} and {van Kempen}, {Zo{\'e} L E} and Joep Killestein",

note = "Publisher Copyright: Copyright {\textcopyright} 2020 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology. Copyright: This record is sourced from MEDLINE/PubMed, a database of the U.S. National Library of Medicine",

year = "2021",

month = jan,

day = "1",

doi = "https://doi.org/10.1212/NXI.0000000000000904",

language = "English",

volume = "8",

journal = "Neurology neuroimmunology & neuroinflammation",

issn = "2332-7812",

publisher = "Lippincott, Williams & Wilkins",

number = "1",

}

TY - JOUR

T1 - Mild progressive multifocal leukoencephalopathy after switching from natalizumab to ocrelizumab

AU - Toorop, Alyssa A

AU - van Lierop, Zoë Y G

AU - Strijbis, Eva E M

AU - Teunissen, Charlotte E

AU - Petzold, Axel

AU - Wattjes, Mike P

AU - Barkhof, Frederik

AU - de Jong, Brigit A

AU - van Kempen, Zoé L E

AU - Killestein, Joep

N1 - Publisher Copyright: Copyright © 2020 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology. Copyright: This record is sourced from MEDLINE/PubMed, a database of the U.S. National Library of Medicine

PY - 2021/1/1

Y1 - 2021/1/1

N2 - OBJECTIVE: To describe the disease course of carryover progressive multifocal leukoencephalopathy (PML) after switching from natalizumab to ocrelizumab in 2 patients with relapsing-remitting MS.METHODS: Two case reports with 1 year of follow-up and retrospective longitudinal measurements of serum neurofilament light (NfL) levels and B-cells.RESULTS: PML was diagnosed 78 days (case 1) and 97 days (case 2) after discontinuation of natalizumab. Both patients developed mild immune reconstitution inflammatory syndrome (IRIS) despite B-cell depletion caused by ocrelizumab. NfL levels increased in both patients during PML-IRIS. PML-IRIS lesions stabilized after treatment with mefloquine and mirtazapine, followed by methylprednisolone, and both patients continued therapy with ocrelizumab when B-cells started to repopulate.CONCLUSIONS: The clinical course of carryover PML was mild in both patients, suggesting that B-cell depletion possibly did not aggravate PML-IRIS in these 2 patients.

AB - OBJECTIVE: To describe the disease course of carryover progressive multifocal leukoencephalopathy (PML) after switching from natalizumab to ocrelizumab in 2 patients with relapsing-remitting MS.METHODS: Two case reports with 1 year of follow-up and retrospective longitudinal measurements of serum neurofilament light (NfL) levels and B-cells.RESULTS: PML was diagnosed 78 days (case 1) and 97 days (case 2) after discontinuation of natalizumab. Both patients developed mild immune reconstitution inflammatory syndrome (IRIS) despite B-cell depletion caused by ocrelizumab. NfL levels increased in both patients during PML-IRIS. PML-IRIS lesions stabilized after treatment with mefloquine and mirtazapine, followed by methylprednisolone, and both patients continued therapy with ocrelizumab when B-cells started to repopulate.CONCLUSIONS: The clinical course of carryover PML was mild in both patients, suggesting that B-cell depletion possibly did not aggravate PML-IRIS in these 2 patients.

UR - http://www.scopus.com/inward/record.url?scp=85092886785&partnerID=8YFLogxK

U2 - https://doi.org/10.1212/NXI.0000000000000904

DO - https://doi.org/10.1212/NXI.0000000000000904

M3 - Article

C2 - 33051344

SN - 2332-7812

VL - 8

JO - Neurology neuroimmunology & neuroinflammation

JF - Neurology neuroimmunology & neuroinflammation

IS - 1

ER -

Mild progressive multifocal leukoencephalopathy after switching from natalizumab to ocrelizumab

Abstract

Access to Document

Other files and links

Cite this