This Could Potentially Be Used To Prevent the Risk of Serious Brain Infection In MS Patients
An optimal treatment course has been delineated for individuals suffering from multiple sclerosis (MS) who are currently on medication that potentially exposes them to a severe brain infection.
Those with MS who are prescribed the highly potent drug natalizumab are routinely checked for their susceptibility to developing a life-threatening brain disorder named progressive multifocal leukoencephalopathy (PML), triggered by the John Cunningham virus (JCV).
Despite the relatively low risk of developing PML, the outlook for those affected is dire, with an average lifespan of only six months post-diagnosis.
If biannual blood tests reveal a heightened risk of JCV, it is common for patients to change medication. However, stopping the use of natalizumab can expose patients to severe MS flare-ups. Until recently, the most effective alternative drug remained unclear.
A recent article in JAMA Neurology, however, has clarified which among the drugs dimethyl fumarate, fingolimod, and ocrelizumab is the most beneficial following the cessation of natalizumab.
Scientists studied real-world information from the international MSBase registry, which tracks the health outcomes of more than 89,000 MS patients.
The research pinpointed 1,386 global patients who had transitioned from natalizumab to dimethyl fumarate, fingolimod, or ocrelizumab.
Among patients who had discontinued natalizumab, ocrelizumab proved the most effective. Ocrelizumab had fewer instances of relapse and lower discontinuation rates compared to dimethyl fumarate and fingolimod.
The leading author, Dr. Chao Zhu from the Department of Neuroscience at Monash University Central Clinical School, emphasized the global significance of these findings for medical practitioners and patients. According to him, these insights could guide therapeutic decisions and optimize strategies for patients required to cease the use of natalizumab.
The range of treatment alternatives in some nations is constrained due to the hefty production costs associated with the latest, more efficient medicines. Furthermore, stringent protocols on initial line of treatment or restrictions on the use of certain drugs for women planning to have children also limit the available options.
Professor Helmut Butzkueven, a senior author and member of both the Department of Neuroscience at Monash University Central Clinical School and Alfred’s Department of Neurology, emphasized the necessity for healthcare professionals to utilize blood tests to assess the risk of JCV in MS patients.
“If patients need to change their medication from natalizumab, which is highly effective in treating MS, it can be an anxious and distressing time. Our study helps neurologists and patients make a better-informed choice.”
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