Anti-JC Virus Antibody Status and Use of Immunomodulatory Therapies in Patients with Multiple Sclerosis (P3.094)

/>OBJECTIVES: Study the correlation between JCVab seropositive status and type of IMT. BACKGROUND: Serum anti-JCV antibody (JCVab) testing is used for risk stratification in MS patients treated with drugs with known risk of progressive multifocal encephalopathy (PML) including natalizumab (NTZ), fingolimod (FTY), and dimethylfumarate (DMF). The JCVab+ patients are more likely to stay on other immunomodulatory therapies (OIMT) with no known PML risk e.g. beta-interferon (beta-IFN), glatiramer acetate (GA), and teriflunomide. METHODS: Of total 160 patients with serum JCVab testing in past five years at our MS center, a group of patients with complete data were included. Data on IMT were retrospectively collected to study the difference in IMT use between the JCVab+ and JCVab- groups at time of testing and at six month. RESULTS: Seventy patients (mean age ± SD, 48.5 ± 12.2 years; 73[percnt] women, disease duration ± SD 10.4 ± 6.1 years), 39 JCVab+ (56[percnt]) and 31 JCVab- patients were studied. Baseline IMT in JCVab+ group included NTZ in 20 (51[percnt]), OIMT in 15 (4 beta-IFN, 3 mycophenolate, 7 GA, 1 steroids), no IMT in 4 patients. Baseline IMT in JCVab- patients included PML-associated-IMT in 19 (61[percnt]) patients (17 NTZ, 1 FTY, 1DMF), OIMT in 11 (6 beta-IFN, 2 GA, 1 rituximab, 1 mycophenolate, 1 methotrexate), no IMT in 1 patient. Difference in PML-associated-IMT at baseline was not significant (p=0.4). At six months, significantly higher number (74 vs. 31 [percnt]) were on PML- associated-IMT in JCVab- compared to JCVab+ group (p=<0.001). In JCVab+ group , 50[percnt] switched from PML-associated-IMT to OIMT vs. 10[percnt] from OIMT to PML-associated-IMT (p=0.02). Among JCVab- patients, 67[percnt] changed from OIMT to PML-associated-IMT compared to 21[percnt] from PML- associated-IMT to OIMT (p=NS). CONCLUSION: JCVab positive patients are less likely to stay on PML- associated-IMT compared to JCVab negative patients due to PML risk. Disclosure: Dr. Berrios Morales has nothing to disclose. Dr. Kane has nothing to disclose. Dr. Riskind has received research support from Biogen Idec, Teva, Hoffman Laroche, Genentech, and Novartis. Dr. Griffin has nothing to disclose. Dr. Garg has nothing to disclose.