Natalizumab continuation versus switching to ocrelizumab after PML risk stratification in RRMS patients: a natural experiment

• DOI: 10.1007/s00415-023-11645-x
• Publication Date: 2023-03-26T22:23:49Z
• Authors: Albert Muñoz-Vend...; Pablo Arroyo-Pereiro; Isabel León; Laura Bau; Elisabet Matas; Antonio Martínez-...; Sergio Martínez-Y...; Lucía Romero-Pinel
• Keywords: Natalizumab; Ocrelizumab; JC Virus

Abstract Background Natalizumab (NTZ) and ocrelizumab (OCR) can be used for the treatment of relapsing–remitting multiple sclerosis (RRMS). In patients treated with NTZ, screening JC virus (JCV) is mandatory, a positive serology usually requires change in after 2 years. this study, JCV was as natural experiment to pseudo-randomize into NTZ continuation or OCR. Methods An observational analysis who had received at least years were either changed OCR maintained on depending status, performed. A stratification moment (STRm) established when pseudo-randomized arm (NTZ if negativity, positivity). Primary endpoints include time first relapse presence relapses STRm initiation. Secondary clinical radiological outcomes 1 year. Results Of 67 included, 40 continued (60%) 27 (40%). Baseline characteristics similar. Time not significantly different. Ten + presented (37%), four during washout period, 13 JCV-NTZ (32.5%, p = 0.701). No differences secondary detected year STRm. Conclusions The status compare arms low selection bias. our switching versus led similar disease activity outcomes.