ArticleTherapeutic advances in neurological disorders2021
High rates of JCV seroconversion in a large international cohort of natalizumab-treated patients.
Article in Therapeutic advances in neurological disorders, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 14 citations in OpenAlex.
- Low natalizumab trough concentrations are associated with reduced seroconversion of the John Cunningham virus in natalizumab-treated patients with multiple sclerosis.Journal of neurology, neurosurgery, and psychiatry · 2025Article
- A comparison of JC virus assay performance provided with originator and biosimilar natalizumab.Multiple sclerosis (Houndmills, Basingstoke, England) · 2025Article
- Anti-JCV antibody index seroconversion in Turkish multiple sclerosis patients treated with natalizumab.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Article
- Rates of John Cunningham virus seroconversion greatly reduced in natalizumab-treated patients during COVID-19-related lockdowns.European journal of neurology · 2024Article
- Natalizumab continuation versus switching to ocrelizumab after PML risk stratification in RRMS patients: a natural experiment.Journal of neurology · 2023Observational
- JCV seroconversion rate during the SARS COVID-19 pandemic.Multiple sclerosis and related disorders · 2022Article
- The Oncogenic Roles of JC Virus T Antigen in Breast Carcinogenesis.Frontiers in molecular biosciences · 2021Article
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Authors and funding
17 authors at 8 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsTo retrospectively assess factors associated with John Cunningham virus (JCV) seroconversion in natalizumab-treated patients.
backgroundNatalizumab is highly effective for the treatment of relapsing-remitting multiple sclerosis (RRMS), but its use is complicated by opportunistic JCV infection. This virus can result in progressive multifocal leukoencephalopathy (PML). Serial assessment of JCV serostatus is mandated during natalizumab treatment.
methodsPatients treated with natalizumab for RRMS at six tertiary hospitals in Melbourne, Australia (
resultsFrom a cohort of 1001 natalizumab-treated patients, durable positive seroconversion was observed in 83 of 345 initially JCV negative patients (24.1%; 7.3% per year). Conversely, 16 of 165 initially JCV positive patients experienced durable negative seroconversion (9.7%; 3.8% per year). Forty patients (3.9%) had fluctuating serostatus. Time-to-event analysis did not identify a relationship between JCV seroconversion and duration of natalizumab exposure. Prior exposure to immunosuppression was not associated with an increased hazard of positive JCV seroconversion. Male sex was associated with increased JCV seroconversion risk [adjusted hazard ratio 2.09 (95% confidence interval 1.17-3.71)
conclusionIn this large international cohort of natalizumab-treated patients we observed an annual durable positive seroconversion rate of 7.3%. This rate exceeds that noted in registration and post-marketing studies for natalizumab. This rate also greatly exceeds that predicted by epidemiological studies of JCV seroconversion in healthy populations. Taken together, our findings support emerging evidence that natalizumab causes off-target immune changes that may be trophic for JCV seroconversion. In addition, male sex may be associated with increased positive JCV seroconversion.
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