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- Title
A case of multiple sclerosis with negatively converted anti‐natalizumab antibodies.
- Authors
Miyamoto, Katsuichi; Kusunoki, Susumu
- Abstract
Background: The therapeutic effect of natalizumab, a disease‐modifying drug for multiple sclerosis (MS), may be decreased in the presence of neutralizing antibodies. In particular, if the neutralizing antibody is persistently positive, the treatment must be stopped. We experienced a case in which anti‐natalizumab antibodies were persistently positive but then negatively reversed during the course of treatment. Case presentation: The case is a 38‐year‐old female MS patient. After three attacks of MS, she was treated with dimethyl fumarate, but the relapse continued. Anti‐JC virus titer of her serum was more than 2.5, but she selected to treatment with natalizumab. At her initial treatment, she had allergic symptoms and was found to be positive for anti‐natalizumab antibodies. In the second treatment, she received an infusion after taking antiallergic drugs, after which her allergic symptoms reduced. Thereafter, she received natalizumab treatment in the same manner. Two months later, reexamination of the anti‐natalizumab antibodies was persistently positive. However, she decided to continue natalizumab because there were no recurrences. Two years after the start of natalizumab treatment, the anti‐natalizumab antibodies were found to be negatively inversed. Because anti‐JC virus antibody remained elevated, she decided to continue the treatment with natalizumab by dosing intervals every 6 weeks. Thereafter, no recurrence was observed. Conclusions: Even if the neutralizing antibodies against natalizumab are positive, treatment continuation may be considered if the therapeutic effect is certain and the side effects are within the allowable range.
- Subjects
VIRAL antibodies; JOHN Cunningham virus; IMMUNOGLOBULINS; MULTIPLE sclerosis; TREATMENT effectiveness; DIMETHYL fumarate
- Publication
Clinical & Experimental Neuroimmunology, 2020, Vol 11, Issue 4, p230
- ISSN
1759-1961
- Publication type
Article
- DOI
10.1111/cen3.12596