Item request has been placed! ×
Item request cannot be made. ×
loading  Processing Request

CCR5 Blockade in Inflammatory PML and PML-IRIS Associated With Chronic Inflammatory Diseases' Treatments

Item request has been placed! ×
Item request cannot be made. ×
loading   Processing Request
اقرأ أكثر حفظ في قائمتي
  • معلومة اضافية
    • Contributors:
      Service of Neurology CHUV, Lausanne, Switzerland; Centre Hospitalier Universitaire Vaudois = Lausanne University Hospital Lausanne (CHUV); Université de Lausanne = University of Lausanne (UNIL); Neuro-Dol (Neuro-Dol); Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne (UCA); CHU Clermont-Ferrand; Service de neurologie Poitiers; Centre hospitalier universitaire de Poitiers = Poitiers University Hospital (CHU de Poitiers La Milétrie ); Service Maladies infectieuses et tropicales CHU Toulouse; Pôle Inflammation, infection, immunologie et loco-moteur CHU Toulouse (Pôle I3LM Toulouse); Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse); Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity); Université Toulouse III - Paul Sabatier (UT3); Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS); Service de neurologie Bordeaux; Centre Hospitalier Universitaire de Bordeaux (CHU Bordeaux)-Groupe hospitalier Pellegrin; Service de médecine interne Mondor; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12); Hôpital Pasteur Nice (CHU); Université Côte d'Azur (UniCA); Pôle Neurosciences CHU Toulouse; Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)
    • بيانات النشر:
      HAL CCSD
      American Academy of neurology
    • الموضوع:
      2022
    • Collection:
      Université Toulouse III - Paul Sabatier: HAL-UPS
    • نبذة مختصرة :
      International audience ; Background and objectives: Progressive multifocal leukoencephalopathy (PML) is a disabling neurologic disorder resulting from the infection of the CNS by JC polyomavirus in immunocompromised individuals. For the last 2 decades, increasing use of immunotherapies leads to iatrogenic PML. Iatrogenic PML is often associated with signs of inflammation at onset (inflammatory PML) and/or after treatment withdrawal immune reconstitution inflammatory syndrome (PML-IRIS). Although immune reconstitution is a key element for viral clearance, it may also be harmful and induce clinical worsening. A C-C chemokine receptor type 5 (CCR5) antagonist (maraviroc) has been proposed to prevent and/or limit the deleterious immune responses underlying PML-IRIS. However, the data to support its use remain scarce and disputed.Methods: We conducted a multicenter retrospective cohort study at 8 university hospitals in France and Switzerland by collecting clinical, biological, and radiologic data of patients who developed inflammatory PML (iPML) or PML-IRIS related to immunosuppressive therapies used for chronic inflammatory diseases between 2010 and 2020. We added to this cohort, a meta-analysis of individual case reports of patients with iPML/PML-IRIS treated with maraviroc published up to 2021.Results: Overall, 27 cases were identified in the cohort and 9 from the literature. Among them, 27 met the inclusion criteria: 16 treated with maraviroc and 11 with standard of care (including corticosteroids use). Most cases were related to MS (92.6%) and natalizumab (88%). Inflammatory features (iPML) were present at onset in 12 patients (44.4%), and most patients (92.6%) received corticosteroids within the course of PML. Aggravation due to PML-IRIS was not prevented by maraviroc compared with patients who received only corticosteroids (adjusted odds ratio: 0.408, 95% CI: 0.06-2.63). Similarly, maraviroc did not influence time to clinical worsening due to PML-IRIS (adjusted hazard ratio = 0.529, 95% CI: 0.14-2.0) or ...
    • Relation:
      info:eu-repo/semantics/altIdentifier/pmid/34728496; PUBMED: 34728496; PUBMEDCENTRAL: PMC8564863
    • الرقم المعرف:
      10.1212/NXI.0000000000001097
    • الدخول الالكتروني :
      https://ut3-toulouseinp.hal.science/hal-03670693
      https://ut3-toulouseinp.hal.science/hal-03670693v1/document
      https://ut3-toulouseinp.hal.science/hal-03670693v1/file/Bernard-Valnet_2021.pdf
      https://doi.org/10.1212/NXI.0000000000001097
    • Rights:
      http://creativecommons.org/licenses/by/ ; info:eu-repo/semantics/OpenAccess
    • الرقم المعرف:
      edsbas.384A45AA