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We propose a pragmatic bridging strategy, using another disease-modifying therapy (DMT), to reduce the risk of switching from natalizumab to alemtuzumab. We also discuss the caveats and subtleties associated with sequencing DMTs in MS and the complex decision making involved.<\/jats:p>","DOI":"10.1136\/practneurol-2015-001355","type":"journal-article","created":{"date-parts":[[2016,4,25]],"date-time":"2016-04-25T23:50:51Z","timestamp":1461628251000},"page":"389-393","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":47,"title":["Switching patients at high risk of PML from natalizumab to another disease-modifying therapy"],"prefix":"10.1136","volume":"16","author":[{"given":"Gavin","family":"Giovannoni","sequence":"first","affiliation":[{"name":"Department of Neurosciences, Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK"},{"name":"Department of Neurology, Royal London Hospital, Barts Health NHS Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monica","family":"Marta","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK"},{"name":"Department of Neurology, Royal London Hospital, Barts Health NHS Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angharad","family":"Davis","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK"},{"name":"Department of Neurology, Royal London Hospital, Barts Health NHS Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin","family":"Turner","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK"},{"name":"Department of Neurology, Royal London Hospital, Barts Health NHS Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharmilee","family":"Gnanapavan","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK"},{"name":"Department of Neurology, Royal London Hospital, Barts Health NHS Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Klaus","family":"Schmierer","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK"},{"name":"Department of Neurology, Royal London Hospital, Barts Health NHS Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2016,4,25]]},"reference":[{"key":"2025090409160404000_16.5.389.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1107829"},{"key":"2025090409160404000_16.5.389.2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.24286"},{"key":"2025090409160404000_16.5.389.3","unstructured":"Putzki N , Clifford DB , Bischof D , et al . 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