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Progressive Multifocal Leukoencephalopathy (PML) Risk in patients Treated with Natalizumab

The EBMcalc module Progressive Multifocal Leukoencephalopathy (PML) Risk in patients Treated with Natalizumab is available in EBMcalc Complete Edition.

This Decision TreeCalc evaluates the following decision points:

JC virus antibodies
Was there prior immunosuppresant use
Natalizumab exposure time

Decision Tree end points include:

PML incidence ≤0.09 / 1000 with 95% confidence interval of 0 to 0.48
PML incidence 0.56 / 1000 with 95% confidence interval of 0.36 to 0.83
PML incidence 4.6 / 1000 with 95% confidence interval of 3.7 to 5.6
PML incidence 1.6 / 1000 with 95% confidence interval of 0.91 to 2.6
PML incidence 11.1 / 1000 with 95% confidence interval of 8.3 to 14.5
PML incidence 0.31 / 1000 with 95% confidence interval of 0.2 to 0.45
PML incidence 2.5 / 1000 with 95% confidence interval of 2.1 to 3.1
PML incidence 0.88 / 1000 with 95% confidence interval of 0.5 to 1.4
PML incidence 6.1 / 1000 with 95% confidence interval of 4.6 to 8

References

Bloomgren G, Richman S, Hotermans C, et al. Risk of natalizumab-associated progressive multifocal leukoencephalopathy. N Engl J Med. 2012 May 17;366(20):1870-80. PubMed ID: 22591293
Tur C, Montalban X. Natalizumab: risk stratification of individual patients with multiple sclerosis. CNS Drugs. 2014 Jul;28(7):641-8. PubMed ID: 24942634

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