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Incidence of Seroconversion and Sero-Reversion in Patients With Multiple Sclerosis (Ms) Who Had Been Treated With Natalizumab: A Systematic Review and Meta-Analysis Publisher Pubmed



Azimi A1 ; Hanaei S2, 3 ; Sahraian MA1 ; Mohammadifar M4 ; Ramagopalan SV5 ; Ghajarzadeh M6
Authors
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Authors Affiliations
  1. 1. MS Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Research Center for Immunodeficiencies (RCID), Tehran University of Medical Sciences (TUMS), Tehran, Iran
  3. 3. Universal Scientific Education and Research Network (USERN), Tehran, Iran
  4. 4. Department of Radiology, Zanjan University of Medical Sciences, Zanjan, Iran
  5. 5. Bristol-Myers Squibb, Uxbridge, United Kingdom
  6. 6. Universal Council of Epidemiology (UCE), Universal Scientific Education and Research Network (USERN), Tehran University of Medical Sciences, Tehran, Iran

Source: Journal of Clinical Neuroscience Published:2020


Abstract

Background: Natalizumab is a medication of choice for some patients with relapsing remitting (RR) form of multiple sclerosis (MS). John Cunningham virus (JCV) antibody status is important in cases who are treating with natalizumab. Different studies reported various rates of seroconversion and sero-reversion in patients who had been treated with natalizumab. As there is no systematic review reporting incidence of seroconversion and seroreversion in MS cases who were treated with natalizumab, we aimed to conduct this systematic review and meta-analysis to find pooled incidence of seroconversion and seroreversion in MS cases who were treated with natalizumab. Methods: PubMed, Scopus, EMBASE, CINAHL, Web of Science, Ovid, and google scholar were systematically searched. We also searched the gray literature including references from included studies, and conference abstracts which were published up to April 2019. Results: The incidence of seroconversion was reported between 6% and 41% and the incidence of seroreversion was reported between 1% and 11%. The pooled estimate of seroconversion incidence was 19% (95% CI: 13%–25%) (I2 = 96.8%, P < 0.001) and the pooled estimate of seroreversion incidence was 5% (95% CI: 3%–8%) (I2 = 72.2%, P < 0.001). Subgroup analysis by considering the country of the origin showed that the pooled incidence of seroconversion incidence during the studies was 6% in Asian countries and 21% in European/American countries. The incidence difference between subgroups was significant (p < 0.001). Conclusion: Incidence of seroconversion in MS patients who had been treated with natalizumab is higher in European/American countries than Asian countries. © 2019 Elsevier Ltd
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