Anti-JC virus antibodies in rituximab-treated patients with neuromyelitis optica spectrum disorder

Abstract

Rituximab, a chimeric monoclonal anti-CD20 antibody, has been proposed to be effective for neuromyelitis optica spectrum disorder (NMOSD). A concern for developing progressive multifocal leukoencephalopathy (PML), which is caused by John Cunningham virus (JCV), has been suggested particularly in patients treated long term with rituximab. In this study, using a modified enzyme-linked immunosorbent assay with glutathione S-transferase-tagged VP1 as the antigen, we investigated the seroprevalence of anti-JCV antibodies among 78 Korean patients with NMOSD and the change in anti-JCV antibody serostatus following long-term rituximab treatment. The overall seroprevalence of anti-JCV antibodies was 69 % prior to rituximab administration. Over a mean of 4 years of repeated treatment with rituximab, no patient developed PML. Of 24 initially seronegative patients, none converted into seropositive, whereas six (11 %) of 54 initially seropositive patients converted into seronegative. Our results might support the safety of long-term rituximab treatment in patients with NMOSD with regard to the risk of developing PML.

High Seroprevalence and Index of Anti-John-Cunningham Virus Antibodies in Korean Patients with Multiple Sclerosis

“…There is little information on the seroprevalence of JCV in Asian countries, with especially few reports based on the validated second-generation enzyme-linked immunosorbent assay (ELISA)9 that has been demonstrated to accurately stratify patients according to their risk of PML. In 2014 we reported a rate of 69% for anti-JCV antibodies in 78 patients with neuromyelitis optica spectrum disorder (NMOSD), which was higher than the published rates for MS cohorts in Western countries, suggesting that the rate of JCV seroprevalence is higher in Asian than Western countries 10. Consistent with this hypothesis, a high seroprevalence of anti-JCV antibodies (80%) and a high proportion of patients with an index >1.5 (62% of patients) was reported in Chinese patients with MS 11.…”

Serum anti-John Cunningham virus antibody seroprevalence and index among Japanese patients with neuromyelitis optica spectrum disorders

“…2 Meanwhile, to our knowledge, only one study has reported the JCVAb seroprevalence rate in patients with NMOSD, demonstrating that approximately 70% (54/78) of patients with NMOSD were JCVAb positive. 3…”