{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T07:54:34Z","timestamp":1784274874993,"version":"3.55.0"},"reference-count":10,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\">\n<jats:title>Background:<\/jats:title>\n<jats:p>Progressive multifocal leukoencephalopathy (PML), a potentially fatal demyelinating disease caused by the John Cunningham virus (JCV), can occur as a complication of treatment with rituximab, fingolimod, and dimethyl fumarate. The primary objective of this study was to determine changes in anti-JCV antibody index values in multiple sclerosis (MS) patients treated with these three medications. Second, we explored the relationship between absolute lymphocyte count (ALC), anti-JCV antibody index values, and various patient characteristics.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st2\">\n<jats:title>Methods:<\/jats:title>\n<jats:p>In this retrospective chart review, we evaluated changes in JCV serology and ALC in 172 MS patients treated with fingolimod, rituximab, or dimethyl fumarate (2013\u20132016). Only those with known anti-JCV antibody and ALC values before starting the study medications were included. Subsequent values were obtained on an ad hoc basis throughout the study.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st3\">\n<jats:title>Results:<\/jats:title>\n<jats:p>There was a significant decrease in anti-JCV antibody index values in patients treated with fingolimod and rituximab (<jats:italic>P<\/jats:italic> = 0.03 and <jats:italic>P<\/jats:italic> = 0.014, respectively). A non-significant decreasing trend in anti-JCV antibody index values occurred in patients treated with dimethyl fumarate. Notably, there was no relationship between ALC and anti-JCV antibody index values for patients treated with rituximab, fingolimod, or dimethyl fumarate.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st4\">\n<jats:title>Conclusions:<\/jats:title>\n<jats:p>Anti-JCV antibody index values significantly decreased in MS patients treated with fingolimod and rituximab; however, this did not occur with dimethyl fumarate. Fingolimod and rituximab may impair the humoral response to the JCV. Nevertheless, a declining anti-JCV antibody index in MS patients treated with fingolimod or rituximab should not necessarily be interpreted as correlating with a decreased risk for PML.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni-4-2019","type":"journal-article","created":{"date-parts":[[2019,5,2]],"date-time":"2019-05-02T04:40:26Z","timestamp":1556772026000},"page":"59","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Anti-John Cunningham virus antibody index levels in multiple sclerosis patients treated with rituximab, fingolimod, and dimethyl fumarate"],"prefix":"10.25259","volume":"10","author":[{"given":"Stephen","family":"Farley","sequence":"first","affiliation":[{"name":"Department of Pharmacy, NYU Winthrop Hospital, Mineola, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malcolm H.","family":"Gottesman","sequence":"additional","affiliation":[{"name":"NYU Winthrop Hospital, Mineola, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon","family":"Friedman-Urevich","sequence":"additional","affiliation":[{"name":"NYU Winthrop Hospital, Mineola, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janin","family":"Ye","sequence":"additional","affiliation":[{"name":"New York University, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, NYU Winthrop Hospital, Mineola, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denise","family":"Grueneberg","sequence":"additional","affiliation":[{"name":"NYU Winthrop Hospital, Mineola, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorraine","family":"Martone","sequence":"additional","affiliation":[{"name":"NYU Winthrop Hospital, Mineola, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rose","family":"Calixte","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, NYU Winthrop Hospital, Mineola, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2019,4,24]]},"reference":[{"key":"10.25259\/SNI-4-2019\/ref-1","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.msard.2017.01.006","article-title":"Classifying PML risk with disease modifying therapies","volume":"12","author":"Berger","year":"2017","journal-title":"Mult Scler Relat Disord"},{"key":"10.25259\/SNI-4-2019\/ref-2","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1016\/j.jbspin.2017.03.002","article-title":"Progressive multifocal leukoencephalopathy and rheumatoid arthritis treatments","volume":"84","author":"Clavel","year":"2017","journal-title":"Joint Bone Spine"},{"key":"10.25259\/SNI-4-2019\/ref-3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.2147\/PROM.S122401","article-title":"Long-term safety and real-world effectiveness of fingolimod in relapsing multiple sclerosis","volume":"9","author":"Druart","year":"2018","journal-title":"Patient Relat Outcome Meas"},{"key":"10.25259\/SNI-4-2019\/ref-4","year":"2015","journal-title":"EMA News and Press Releases:New recommendations to Minimize Risks of the Rare Brain Infection PML and a Type of Skin Cancer with Gilenya"},{"key":"10.25259\/SNI-4-2019\/ref-5","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1128\/CMR.05031-11","article-title":"Molecular biology, epidemiology, and pathogenesis of progressive multifocal leukoencephalopathy, the JC virus-induced demyelinating disease of the human brain","volume":"25","author":"Ferenczy","year":"2012","journal-title":"Clin Microbiol Rev"},{"issue":"Suppl 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