FRONT PAGE AMPYRA AUBAGIO AVONEX BETASERON COPAXONE EXTAVIA
Stan's Angels MS News Channel on YouTube GILENYA NOVANTRONE REBIF RITUXAN TECFIDERA TYSABRI
 Daily News for Neuros, Nurses & Savvy MSers: 208,152 Viewers, 8,368 Stories & Studies
Click Here For My Videos, Advice, Tips, Studies and Trials.
Timothy L. Vollmer, MD
Department of Neurology
University of Colorado Health Sciences Center Professor

Co-Director of the RMMSC at Anschutz Medical Center

Medical Director-Rocky Mountain MS Center
Click here to read my columns
Brian R. Apatoff, MD, PhD
Multiple Sclerosis Institute
Center for Neurological Disorders

Associate Professor Neurology and Neuroscience,

Weill Medical College of Cornell University

Clinical Attending in Neurology,
New York-Presbyterian Hospital
CLICK ON THE RED BUTTON BELOW
You'll get FREE Breaking News Alerts on new MS treatments as they are approved
MS NEWS ARCHIVES: by week

HERE'S A FEW OF OUR 6000+ Facebook & MySpace FRIENDS
Timothy L. Vollmer M.D.
Department of Neurology
University of Colorado Health Sciences Center
Co-Director of the RMMSC at Anschutz Medical Center
and
Medical Director-Rocky Mountain MS Center


Click to view 1280 MS Walk photos!

"MS Can Not
Rob You of Joy"
"I'm an M.D....my Mom has MS and we have a message for everyone."
- Jennifer Hartmark-Hill MD
Beverly Dean

"I've had MS for 2 years...this is the most important advice you'll ever hear."
"This is how I give myself a painless injection."
Heather Johnson

"A helpful tip for newly diagnosed MS patients."
"Important advice on choosing MS medication "
Joyce Moore


This page is powered by Blogger. Isn't yours?

Monday

 

STUDY: Benefit of Additional Screening for PML (Progressive Multifocal Leukoencephalopathy) in MSers Taking Tysabri (Natalizumab): A Decision Analysis

Abstract

Patients with multiple sclerosis (MS) taking natalizumab are at risk for progressive multifocal leukoencephalopathy (PML). We sought to describe the outcomes of discontinuing natalizumab on the basis of PML risk and those of obtaining additional screening across a range of scenarios using decision tree models.

Methods
Health state probabilities and values, measured as the proportion of quality–adjusted life years (PQALY) relative to baseline health, were based on literature review. Probabilities of worsening MS while continuing and discontinuing natalizumab were set to 0.23 and 0.44. For discontinuing therapy, PML risk, worsening MS value, and PML value were varied. For additional screening, the probability of discontinuing natalizumab without screening, PML risk, worsening MS value, and PML value were set to 33%, 1.1%, 0.88, and 0.09, respectively, with test sensitivity and specificity varying from 0.50 to 1.

Results
Discontinuing natalizumab provided no benefit until PML risk reached 2.9%, assuming an MS relapse value of 0.88 and a PML value of 0.09. Additional screening changed the PQALY by −0.3% to 1.5%, largely influenced by specificity. Assuming a sensitivity of 80% and a specificity of 99%, screening increases the PQALY by 1.2%.

Conclusions
The highest PML risk identified by stratification is below 2.9%, suggesting that continuing natalizumab outweighs PML risk for most patients on the basis of theoretical calculations. However, decisions based on additional screening with high-specificity tests, including polymerase chain reaction cerebrospinal fluid tests for John Cunningham virus, may provide benefit and should be clinically tested. Increased precision of probabilities and quality-of-life values are also needed to improve decision making.
Click here to read more

Labels: , , , ,



Go to Newer News Go to Older News