PML and rheumatology: the contribution of disease and drugs.

Hdl Handle:
http://hdl.handle.net/10147/220932
Title:
PML and rheumatology: the contribution of disease and drugs.
Authors:
Molloy, Eamonn S
Affiliation:
Department of Rheumatology, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland. E.Molloy@st-vincents.ie
Citation:
PML and rheumatology: the contribution of disease and drugs. 2011, 78 Suppl 2:S28-32 Cleve Clin J Med
Journal:
Cleveland Clinic journal of medicine
Issue Date:
Nov-2011
URI:
http://hdl.handle.net/10147/220932
DOI:
10.3949/ccjm.78.s2.07
PubMed ID:
22123931
Abstract:
Progressive multifocal leukoencephalopathy (PML), a rare, typically fatal, opportunistic infection caused by the JC virus, is becoming relevant to physicians in multiple specialties, including those who prescribe biologic agents for the treatment of autoimmune disorders. Reports of PML have led to US Food and Drug Administration alerts and warning letters regarding four immunosuppressive agents in recent years (natalizumab, rituximab, efalizumab, and mycophenolate mofetil). Consequently, informed clinical decision-making requires understanding the risk of PML associated with these therapies. An estimate of the relative frequency of PML associated with specific rheumatic conditions has been generated. Systemic lupus erythematosus appears to be associated with susceptibility to PML that cannot be fully explained by the intensity of immunosuppressive therapy. Further, the use of rituximab in patients with rheumatic disease has raised concerns. However, definitive attribution of cause is precluded by the limitations of the currently available data. All patients with rheumatic disease, regardless of the intensity of their current immunosuppressive therapy, should be considered potentially at risk of PML. With an evolving understanding of a greater clinical heterogeneity of PML, advances in diagnostic methods, and significant implications for therapy, PML should be considered in the differential diagnosis of neurologic manifestations of rheumatic diseases.
Item Type:
Article
Language:
en
MeSH:
Antibodies, Monoclonal; Antibodies, Monoclonal, Murine-Derived; Autoimmune Diseases; Humans; Immunoconjugates; Immunologic Factors; Immunosuppressive Agents; Leukoencephalopathy, Progressive Multifocal; Mycophenolic Acid
ISSN:
1939-2869

Full metadata record

DC FieldValue Language
dc.contributor.authorMolloy, Eamonn Sen_GB
dc.date.accessioned2012-04-27T12:14:44Z-
dc.date.available2012-04-27T12:14:44Z-
dc.date.issued2011-11-
dc.identifier.citationPML and rheumatology: the contribution of disease and drugs. 2011, 78 Suppl 2:S28-32 Cleve Clin J Meden_GB
dc.identifier.issn1939-2869-
dc.identifier.pmid22123931-
dc.identifier.doi10.3949/ccjm.78.s2.07-
dc.identifier.urihttp://hdl.handle.net/10147/220932-
dc.description.abstractProgressive multifocal leukoencephalopathy (PML), a rare, typically fatal, opportunistic infection caused by the JC virus, is becoming relevant to physicians in multiple specialties, including those who prescribe biologic agents for the treatment of autoimmune disorders. Reports of PML have led to US Food and Drug Administration alerts and warning letters regarding four immunosuppressive agents in recent years (natalizumab, rituximab, efalizumab, and mycophenolate mofetil). Consequently, informed clinical decision-making requires understanding the risk of PML associated with these therapies. An estimate of the relative frequency of PML associated with specific rheumatic conditions has been generated. Systemic lupus erythematosus appears to be associated with susceptibility to PML that cannot be fully explained by the intensity of immunosuppressive therapy. Further, the use of rituximab in patients with rheumatic disease has raised concerns. However, definitive attribution of cause is precluded by the limitations of the currently available data. All patients with rheumatic disease, regardless of the intensity of their current immunosuppressive therapy, should be considered potentially at risk of PML. With an evolving understanding of a greater clinical heterogeneity of PML, advances in diagnostic methods, and significant implications for therapy, PML should be considered in the differential diagnosis of neurologic manifestations of rheumatic diseases.en_GB
dc.language.isoenen
dc.rightsArchived with thanks to Cleveland Clinic journal of medicineen_GB
dc.subject.meshAntibodies, Monoclonal-
dc.subject.meshAntibodies, Monoclonal, Murine-Derived-
dc.subject.meshAutoimmune Diseases-
dc.subject.meshHumans-
dc.subject.meshImmunoconjugates-
dc.subject.meshImmunologic Factors-
dc.subject.meshImmunosuppressive Agents-
dc.subject.meshLeukoencephalopathy, Progressive Multifocal-
dc.subject.meshMycophenolic Acid-
dc.titlePML and rheumatology: the contribution of disease and drugs.en_GB
dc.typeArticleen
dc.contributor.departmentDepartment of Rheumatology, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland. E.Molloy@st-vincents.ieen_GB
dc.identifier.journalCleveland Clinic journal of medicineen_GB
dc.description.provinceLeinsteren
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