{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T01:07:17Z","timestamp":1790298437325,"version":"4.1.0"},"reference-count":39,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2014,10,9]],"date-time":"2014-10-09T00:00:00Z","timestamp":1412812800000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006314","name":"Biogen Idec","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100006314","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ann Clin Transl Neurol"],"published-print":{"date-parts":[[2014,10]]},"abstract":"Abstract<\/jats:title>\n \n Objective<\/jats:title>\n \n As of 3 September 2013, 399 cases of natalizumab\u2010associated progressive multifocal leukoencephalopathy (\n PML<\/jats:styled-content>\n ) were confirmed in multiple sclerosis (\n MS<\/jats:styled-content>\n ) patients. We evaluated outcomes of natalizumab\u2010treated\n MS<\/jats:styled-content>\n patients who were asymptomatic at\n PML<\/jats:styled-content>\n diagnosis.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Analyses included data available as of 5 June 2013. Asymptomatic patients diagnosed with\n PML<\/jats:styled-content>\n by magnetic resonance imaging (\n MRI<\/jats:styled-content>\n ) findings and\n JC<\/jats:styled-content>\n virus\n DNA<\/jats:styled-content>\n detection in the central nervous system were compared with patients presenting with symptoms at diagnosis. Demographics,\n MRI<\/jats:styled-content>\n , and survival over 12\u00a0months were analyzed. Expanded Disability Status Scale (\n EDSS<\/jats:styled-content>\n ) and Karnofsky Performance Scale (\n KPS<\/jats:styled-content>\n ) scores were recorded pre\u2010\n PML<\/jats:styled-content>\n , at diagnosis, and at 6 and 12\u00a0months post\u2010diagnosis.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 372\n PML<\/jats:styled-content>\n cases were analyzed; 30 patients were asymptomatic and 342 were symptomatic at\n PML<\/jats:styled-content>\n diagnosis. Classifications of\n PML<\/jats:styled-content>\n lesions on\n MRI<\/jats:styled-content>\n in asymptomatic versus symptomatic patients were unilobar in 68% versus 37%, multilobar in 21% versus 24%, and widespread in 11% versus 40%. In both groups with unilobar lesions, frontal lobe lesions predominated. Prior to\n PML<\/jats:styled-content>\n , mean\n EDSS<\/jats:styled-content>\n and\n KPS<\/jats:styled-content>\n scores were similar for asymptomatic and symptomatic patients. At diagnosis, mean\n EDSS<\/jats:styled-content>\n score was significantly lower for asymptomatic patients (4.1;\n n\u00a0<\/jats:italic>\n =\n \u00a0<\/jats:italic>\n 11) than for symptomatic patients (5.4;\n n\u00a0<\/jats:italic>\n =\n \u00a0<\/jats:italic>\n 193;\n P\u00a0<\/jats:italic>\n =\n \u00a0<\/jats:italic>\n 0.038). Six months after\n PML<\/jats:styled-content>\n diagnosis, asymptomatic patients had less functional disability than symptomatic patients. As of 5 June 2013, 96.7% of asymptomatic patients and 75.4% of symptomatic patients were alive.\n <\/jats:p>\n <\/jats:sec>\n \n Interpretation<\/jats:title>\n \n PML<\/jats:styled-content>\n patients asymptomatic at diagnosis had better survival and less functional disability than those who were symptomatic at diagnosis.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/acn3.114","type":"journal-article","created":{"date-parts":[[2014,10,9]],"date-time":"2014-10-09T01:33:46Z","timestamp":1412818426000},"page":"755-764","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":122,"title":["Outcome and survival of asymptomatic\n PML<\/scp>\n in natalizumab\u2010treated\n MS<\/scp>\n patients"],"prefix":"10.1002","volume":"1","author":[{"given":"Tuan","family":"Dong\u2010Si","sequence":"first","affiliation":[{"name":"Drug Safety and Risk Management Biogen Idec Inc. Cambridge Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Richman","sequence":"additional","affiliation":[{"name":"Drug Safety and Risk Management Biogen Idec Inc. Cambridge Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mike P.","family":"Wattjes","sequence":"additional","affiliation":[{"name":"MS Center Amsterdam Department of Radiology Nuclear Medicine & PET Research VU University Medical Center Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Made","family":"Wenten","sequence":"additional","affiliation":[{"name":"Drug Safety and Risk Management Biogen Idec Inc. Cambridge Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Gheuens","sequence":"additional","affiliation":[{"name":"Drug Safety and Risk Management Biogen Idec Inc. Cambridge Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Philip","sequence":"additional","affiliation":[{"name":"Data Sciences Biogen Idec Inc. Cambridge Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shoibal","family":"Datta","sequence":"additional","affiliation":[{"name":"Data Sciences Biogen Idec Inc. Cambridge Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"McIninch","sequence":"additional","affiliation":[{"name":"Data Sciences Biogen Idec Inc. Cambridge Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Bozic","sequence":"additional","affiliation":[{"name":"Drug Safety and Risk Management Biogen Idec Inc. Cambridge Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary","family":"Bloomgren","sequence":"additional","affiliation":[{"name":"Drug Safety and Risk Management Biogen Idec Inc. Cambridge Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy","family":"Richert","sequence":"additional","affiliation":[{"name":"Neurology Research and Development Biogen Idec Inc. Cambridge Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,10,9]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"Tysabri (natalizumab)[prescribing information].Cambridge MA:Biogen Idec Inc. 2013."},{"key":"e_1_2_8_3_1","unstructured":"European Medicines Agency.Tysabri (natalizumab) summary of product characteristics. 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