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       #Post#: 3415--------------------------------------------------
       (Abst.) DMTs and PML in MS: A systematic review and meta-analysi
       s
       By: agate Date: September 23, 2021, 12:43 am
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       [font=merriweather]From PubMed (September 22, 2021). The
       abstract that comes up with the link is difficult to read, and
       so I've copied it here.[/font]
  HTML https://pubmed.ncbi.nlm.nih.gov/34547511/
       [quote]
       [font=blinkmacsystemfont]J Neuroimmunol [/font]2021 Sep
       15;360:577721.[font=blinkmacsystemfont]Online ahead of
       print.[/font]
       Disease-modifying therapies and progressive multifocal
       leukoencephalopathy in multiple sclerosis: A systematic review
       and meta-analysis
       [font=blinkmacsystemfont]Background:[/font]
       [font=blinkmacsystemfont]High-efficacy disease-modifying
       therapies (DMT) in the management of multiple sclerosis (MS)
       have a favorable effect on relapse rate and disability
       progression; however, they can expose patients to significant
       risks, such as progressive multifocal leukoencephalopathy
       (PML).[/font]
       [font=verdana][font=blinkmacsystemfont]Objective:[/font][/font]
       [font=verdana][/font]
       [font=verdana][font=blinkmacsystemfont]The study aims to
       investigate prognostic factors that can determine outcome in
       MS-related PML patients.[/font][/font]
       [font=verdana][font=blinkmacsystemfont]Methods:[/font][/font]
       [font=verdana][font=blinkmacsystemfont]We conducted a literature
       review and meta-analysis of 194 patients from 62 articles in
       PubMed, SCOPUS and EMBASE. [/font][/font]
       [font=verdana][font=blinkmacsystemfont]Results:[/font][/font]
       [font=verdana][font=blinkmacsystemfont]Out of 194 patients
       (66.5% women, 33.5% men), 81% had progression in their EDSS
       score by at least 1 point from the time of PML diagnosis (EDSS-P
       group). The remaining patients had either stable or improved
       EDSS (EDSS-S group). In univariate analysis, older age at the
       time of PML diagnosis was associated with higher probability of
       disability accumulation and worsening of EDSS by at least 1
       point (mean age = 44.8, p = 0.046). After adjusting for other
       variables, age at time of PML diagnosis remained a significant
       predictive variable in the multivariable logistic model (OR =
       0.93, 95% CI: 0.88-0.99, p = 0.037). [/font][/font]
       [font=verdana][font=blinkmacsystemfont]Natalizumab is the most
       commonly associated DMT linked to PML, followed by fingolimod
       and others including dimethyl fumarate, ocrelizumab,
       alemtuzumab. Among the different treatments used, no therapeutic
       agent was found to be superior in improving post-PML
       EDSS.[/font][/font]
       [font=verdana][font=blinkmacsystemfont]Conclusions:[/font][/font
       ]
       [font=verdana][font=blinkmacsystemfont]Younger age and lower JCV
       viral load at the time of PML diagnosis were associated with
       better outcome in MS-associate PML, while none of the PML
       therapies was superior over the others or associated with
       favorable outcome.[/font][/font][/quote]
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