TY - JOUR
T1 - Prediction of antibody persistency from antibody titres to natalizumab
AU - Jensen, Poul Erik H
AU - Koch-Henriksen, Nils
AU - Sellebjerg, Finn
AU - Sørensen, Per S
PY - 2012/10
Y1 - 2012/10
N2 - Background:In a subgroup of patients with multiple sclerosis natalizumab therapy causes generation of anti-natalizumab antibodies that may be transient or persistent. It is recommended to discontinue natalizumab therapy in persistently antibody-positive patients.Objective:To use titres of anti-natalizumab antibodies to predict persistency of antibodies.Patients and methods:In 525 consecutive natalizumab treated patients tested for anti-natalizumab antibodies 43 (8.2%) were antibody-positive. Thirty of the antibody-positive patients, who were tested both at three and at six months after treatment start, had antibody titres in blood measured using an extended ELISA method.Results:Samples from persistently positive patients (N=18) had higher titre values than samples from transiently positive patients (N=12). A cut-off value for high titre values was generated, above which patients may discontinue natalizumab therapy after three months. The method had a sensitivity of 0.83, a specificity of 1.00 and a diagnostic accuracy of 0.90.Conclusion:An extended ELISA method for measuring anti-natalizumab antibody titres in multiple sclerosis patients on natalizumab therapy may be used for evaluation of antibody persistence. A test at three months may identify patients with high titres, who should discontinue natalizumab therapy, and patients with transient low-titre antibodies, who may continue natalizumab therapy despite development of antibodies.
AB - Background:In a subgroup of patients with multiple sclerosis natalizumab therapy causes generation of anti-natalizumab antibodies that may be transient or persistent. It is recommended to discontinue natalizumab therapy in persistently antibody-positive patients.Objective:To use titres of anti-natalizumab antibodies to predict persistency of antibodies.Patients and methods:In 525 consecutive natalizumab treated patients tested for anti-natalizumab antibodies 43 (8.2%) were antibody-positive. Thirty of the antibody-positive patients, who were tested both at three and at six months after treatment start, had antibody titres in blood measured using an extended ELISA method.Results:Samples from persistently positive patients (N=18) had higher titre values than samples from transiently positive patients (N=12). A cut-off value for high titre values was generated, above which patients may discontinue natalizumab therapy after three months. The method had a sensitivity of 0.83, a specificity of 1.00 and a diagnostic accuracy of 0.90.Conclusion:An extended ELISA method for measuring anti-natalizumab antibody titres in multiple sclerosis patients on natalizumab therapy may be used for evaluation of antibody persistence. A test at three months may identify patients with high titres, who should discontinue natalizumab therapy, and patients with transient low-titre antibodies, who may continue natalizumab therapy despite development of antibodies.
U2 - 10.1177/1352458512441688
DO - 10.1177/1352458512441688
M3 - Journal article
C2 - 22454098
SN - 1352-4585
VL - 18
SP - 1493
EP - 1499
JO - Multiple Sclerosis Journal
JF - Multiple Sclerosis Journal
IS - 10
ER -