Hello Sara,
First, a study about increased JCV conversion on Tysabri which is self-explanatory.
IMO, it is logical to believe that those who are JCV- and go from 4 week dosing to extended dosing would convert to positive less frequently. Remember, the JC virus alone causes PML so if you don’t have it you can’t get PML unless you convert to positive. I would think any neuro would respond to a patient’s concern about conversion and agree to dose extension.
No, it is true, we don’t have class 1 evidence that dose extension prevents conversion from negative to positive but I bet time and data will reflect that someday. I draw that inference from the first study listed. If more tysabri leads to more conversions, why wouldn't less Tysabri lead to less conversions?
All of the remaining links are the same basic Ryerson study in different forms with clarifying comments. You may have to sign in to the ECTRIMS library but it is totally safe.
Therapy with natalizumab is associated with high JCV seroconversion and rising JCV index values
http://nn.neurology.org/content/3/1/e195
Here is Ryerson making her presentation and some links & comments you may find helpful regarding dose extension:
http://onlinelibrary.ectrims-congres...hown.html?f=m3
This is a print article dated Oct. 7, 2015 which helps explain Ryerson’s research:
New Data Show Longer Natalizumab Dosing Interval in MS Is Feasible
https://www.medpagetoday.com/clinica...eun=g338268d0r
Sara, keep in mind that sufficient patient years to achieve statistical significance had not been achieved when the article was written in 2015 but have been since.
You will find the following site and this post of March 9, 2018 helpful, I’m sure:
Guest Post: Extending natalizumab dosing interval may reduce the risk of PML
http://multiple-sclerosis-research.b...arch?q=ryerson
Same study presented with additional comments:
Extending the Dose interval of natalizumab
http://multiple-sclerosis-research.b...talizumab.html
First, a study about increased JCV conversion on Tysabri which is self-explanatory.
IMO, it is logical to believe that those who are JCV- and go from 4 week dosing to extended dosing would convert to positive less frequently. Remember, the JC virus alone causes PML so if you don’t have it you can’t get PML unless you convert to positive. I would think any neuro would respond to a patient’s concern about conversion and agree to dose extension.
No, it is true, we don’t have class 1 evidence that dose extension prevents conversion from negative to positive but I bet time and data will reflect that someday. I draw that inference from the first study listed. If more tysabri leads to more conversions, why wouldn't less Tysabri lead to less conversions?
All of the remaining links are the same basic Ryerson study in different forms with clarifying comments. You may have to sign in to the ECTRIMS library but it is totally safe.
Therapy with natalizumab is associated with high JCV seroconversion and rising JCV index values
http://nn.neurology.org/content/3/1/e195
Here is Ryerson making her presentation and some links & comments you may find helpful regarding dose extension:
http://onlinelibrary.ectrims-congres...hown.html?f=m3
This is a print article dated Oct. 7, 2015 which helps explain Ryerson’s research:
New Data Show Longer Natalizumab Dosing Interval in MS Is Feasible
https://www.medpagetoday.com/clinica...eun=g338268d0r
Sara, keep in mind that sufficient patient years to achieve statistical significance had not been achieved when the article was written in 2015 but have been since.
You will find the following site and this post of March 9, 2018 helpful, I’m sure:
Guest Post: Extending natalizumab dosing interval may reduce the risk of PML
http://multiple-sclerosis-research.b...arch?q=ryerson
Same study presented with additional comments:
Extending the Dose interval of natalizumab
http://multiple-sclerosis-research.b...talizumab.html
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