Neuroaxonal damage in natalizumab-treated MS patients: The role of JCV antibody titres.

Background: While John Cunningham virus (JCV) is known to cause neuronal damage in progressive multifocal leukoencephalopathy (PML) among natalizumab-treated MS patients, its association with axonal loss in non-PML conditions remains unclear.
Methods: In a cohort of 128 natalizumab-treated MS patients, serum neurofilament (sNfL) levels and JCV antibody titres were measured.
Results: Among 128 patients (mean age = 38.4 years, 71.9% female), 51 (40%) were JCV positive. NfL levels increased by 15.3% for JCV index <0.7 (95% confidence interval [CI] = 0.963-1.381), by 18.6% for index 0.7-1.5 (95% CI = 1.009-1.394) and by 21.1% for index >1.5 (95% CI = 1.040-1.409) compared to JCV negative patients.
Conclusion: These findings indicate a potential link between JCV burden and neuroaxonal degeneration in natalizumab-treated MS patients.
Competing Interests: Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: G.D.C., M.P., T.C., F.S., B.C., A.H., and R.G. report no disclosures. VM has received honoraria for activities with Biogen, Merck, Bayer, TEVA and Sanofi-Genzyme as a speaker. L.M. has received honoraria for speaking in scientific meetings and for advisory board from Biogen TEVA, Sanofi-Genzyme, and Merck. R.F. has received honoraria for speaker activities from Biogen, Merck, Novartis, Roche and Teva. L.L. has received honoraria for consulting services and/or speaking activity from Biogen, Novartis and Excemed. G.C. has received personal compensation for consulting services and/or speaking activities from Novartis, Teva, Sanofi, Sanofi-Genzyme, Merck, Biogen, Excemed, Serono Symposia International Foundation, Roche, Almirall, Receptos, Celgene and Forward Pharma.