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.
Original languageEnglish
JournalMultiple sclerosis journal - experimental, translational and clinical
Issue number2
Publication statusPublished - 2021


  • JC virus
  • Multiple sclerosis
  • disease activity
  • natalizumab
  • ocrelizumab
  • progressive multifocal leukoencephalopathy

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