Ocrelizumab after natalizumab in JC-virus positive relapsing remitting multiple sclerosis patients.

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.

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Déclaration de conflit d'intérêts

Declaration of conflicting interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship and/or publication of this article: Z.Y.G.J.v.L, A.A.T., E.A.J.W., E.M.M.S., N.F.K., B.M. and Z.L.E.K. have no conflicts of interest. F.B. acts as a consultant to Biogen Idec, Janssen Alzheimer Immunotherapy, Bayer Schering, Merck Serono, Roche, Novartis, Genzyme and Sanofi-aventis; he has received sponsorship from EU-H2020, NWO, SMSR, EU-FP7, TEVA, Novartis and Toshiba; he is on the editorial board of Radiology, Brain, Neuroradiology, Multiple Sclerosis Journal (MSJ) and Neurology; he is supported by the NIHR biomedical research centre at UCLH. C.E.T. has served on advisory boards for Roche, has received nonfinancial support in the form of research consumables from ADx NeuroSciences and Euroimmun, and has performed contract research or received grants from Probiodrug, Biogen, Esai, Toyama, Janssen Prevention Center, Boehringer, Axon Neuroscience, EIP Pharma, PeopleBio, and Roche. J. Killestein reports has accepted speaker and consulting fees from Merck, Biogen, TEVA, Sanofi, Genzyme, Roche, and Novartis.