Evidence map›Paper›PMID 34094729›Full record

ReviewCureus2021

Risk of Progressive Multifocal Leukoencephalopathy in Multiple Sclerosis Patient Treated With Natalizumab: A Systematic Review.

Govinathan Vivekanandan, Ansha P Abubacker, Revathi Myneni, Harsh V Chawla, Aimen Iqbal, Amit Grewal, Andrew Ndakotsu, Safeera Khan

Open access · diamondAbstract readReview
In one paragraph

Review in Cureus, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
0.9field-weighted citation impact, top 23% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.

  1. Pooled it
  2. Adoptive T-cell therapy for virus-associated diseases.Clinical microbiology reviews · 2025
    Review
  3. Article
  4. Article
  5. Article
  6. Article
  7. Review
  8. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Govinathan VivekanandanInternal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA.
Ansha P AbubackerEmergency Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA.
Revathi MyneniInternal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA.
Harsh V ChawlaInternal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA.
Aimen IqbalInternal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA.
Amit GrewalInternal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA.
Andrew NdakotsuInternal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA.
Safeera KhanInternal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA.
California Institute of Behavioral Neurosciences and Psychology (United States) · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Natalizumab, a monoclonal antibody acting on alpha4 integrin receptors, is frequently used to treat multiple sclerosis patients. The biggest downside is the risk of development of progressive multifocal leukoencephalopathy, an immune-related condition affecting mainly the central nervous system. The presence of the John Cunningham virus (JCV) and its reactivation is an important factor in the development of progressive multifocal leukoencephalopathy (PML). This study highlights its different proposed mechanism and risk factors strongly related to natalizumab-induced progressive multifocal leukoencephalopathy. The pieces of literature will also be reviewed to look for a relation between the JCV and natalizumab-induced progressive multifocal leukoencephalopathy in multiple sclerosis treated patients. The articles were searched from three databases and reviewed systematically. The inclusion criteria for this study were patients aged 20-50 years, English language paper, full-text availability, and human studies, whereas articles on patients with AIDS and cancer-related disease prior to natalizumab treatment were excluded. Out of 6531 articles identified after applying the search strategy on three main databases PubMed, Google Scholar, and ResearchGate, a total of 32 articles were finalized for the review. This study follows the guidelines listed in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist 2009. The data collected from these finalized articles were pertaining to the risk factor related to natalizumab induced progressive multifocal leukoencephalopathy and the mechanism related to its pathogenesis.  Natalizumab is known to have the potential to cause progressive multifocal leukoencephalopathy in treated patients; here, we evaluate a close relationship of its related risk factors. The articles studied exhibit a close relationship between the length of natalizumab treatment and the presence of the JCV before infusion of natalizumab. From our analysis, it seems that the mechanism related to natalizumab-induced PML is strongly related to antigen-specific T cells and its effects. The frequency of monitoring and vigilance on the management of patients treated with natalizumab will help detect progressive multifocal leukoencephalopathy.

Indexed as

monoclonal antibodynatalizumabprogressive multifocal leukoencephalopathy

Identifiers

PMID34094729
PMCPMC8169000
OpenAlexW3158806300

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.