Article Text

Natalizumab and progressive multifocal leucoencephalopathy
  1. J R Berger
  1. Department of Neurology, University of Kentucky College of Medicine, Lexington, KY, USA
  1. Correspondence to:
    Dr J R Berger
    Department of Neurology, University of Kentucky College of Medicine, Kentucky Clinic L-445, 740 S Limestone Street, Lexington, KY 40536-0284, USA; jrbneuro{at}


Current data suggest that as many as 1 in 1000 treated individuals may develop progressive multifocal leucoencephalopathy (PML) in concert with the use of natalizumab. Natalizumab was withdrawn in early 2005. The present paper provides a comprehensive description of PML and reviews the role of natalizumab in the pathogenesis of PML. It is likely that use of drugs which cause specific perturbations of the immune system will be accompanied by similar rare infections. Thus researchers should be on the alert when using such agents in clinical trials.

  • AIDS, acquired immune deficiency syndrome
  • CNS, central nervous system
  • CSF, cerebrospinal fluid
  • HAART, highly active antiretroviral therapy
  • HIV, human immunodeficiency virus
  • JCV, JC virus
  • MS, multiple sclerosis
  • PML, progressive multifocal leucoencephalopathy
  • natalizumab
  • progressive multifocal leucoencephalopathy
  • demyelination
  • multiple sclerosis
  • monoclonal antibodies

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  • Competing interests: none declared

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