JC Virus Reactivation in Multiple Sclerosis

NCT ID: NCT02004444

Last Updated: 2016-01-29

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

50 participants

Study Classification

OBSERVATIONAL

Study Start Date

2010-10-31

Study Completion Date

2016-01-31

Brief Summary

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JC virus is a benign virus which infects approximately up to 90% of the normal adult population. However, it may be reactivated in people who have a decreased immune function as in HIV infection, cancer, chemotherapy, transplant recipients, or in MS patients treated with natalizumab (Tysabri). In these patients, JC virus can cause a severe brain disease called Progressive Multifocal Leukoencephalopathy (PML), for which there is no cure.

As of September 2013, 400 MS patients in the world, who have been treated with natalizumab, have developed PML. The risk of PML is approximately 5 patients in 1000 after 24 months on the drug. Researchers do not know exactly in which cells of the body the virus lives but it has been isolated from the blood, urine, cerebrospinal fluid (CSF), and from the brains of patients with immunosuppression.

In this study, the investigators wish to determine precisely where the virus lives, and how the body prevents it from causing brain disease.

Because of the association of PML with natalizumab, the investigators would like to see if there is a difference in the amounts of virus in blood, urine, and CSF found in MS patients treated with natalizumab or those treated with different medications for MS, or those not treated at all. The investigators hope that this knowledge will allow us to find better ways of preventing the development of PML as well as treatments for patients with PML.

Detailed Description

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Subjects selected for participation in this study have been diagnosed with Multiple Sclerosis (MS). Of the MS patients enrolled in the study, some have been treated with natalizumab or a different medication for MS, and others have not been treated at all. All MS patients enrolled have their blood tested for the presence of the JC virus. Those testing negative for the JC virus do not continue in the study. Those testing positive for the JC virus continue participating in the study, and provide a urine sample, blood sample, lumbar puncture, and a neurological exam. Approximately 65 people will take part in this study at Beth Israel Deaconess Medical Center.

Conditions

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Progressive Multifocal Leukoencephalopathy Multiple Sclerosis

Keywords

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JC Virus Natalizumab

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

CROSS_SECTIONAL

Study Groups

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Natalizumab 18 months

10 patients on continuous natalizumab monotherapy for 18 months

No interventions assigned to this group

Natalizumab 24 months

10 patients on continuous natalizumab monotherapy for 24 months

No interventions assigned to this group

Natalizumab 36 months

10 patients on continuous natalizumab monotherapy for 36 months

No interventions assigned to this group

IFN-beta 36 months

10 patients on continuous interferon-beta monotherapy for 36 months

No interventions assigned to this group

Untreated

10 untreated patients

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* Clinical diagnosis of Multiple Sclerosis, relapsing remitting

Exclusion Criteria

* JCV sero-negative
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Multiple Sclerosis Society

OTHER

Sponsor Role collaborator

Biogen

INDUSTRY

Sponsor Role collaborator

Beth Israel Deaconess Medical Center

OTHER

Sponsor Role lead

Responsible Party

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Igor Koralnik

Chief, Division of NeuroVirology

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Igor J Koralnik, MD

Role: PRINCIPAL_INVESTIGATOR

Beth Israel Deaconess Medical Center

Locations

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Beth Israel Deaconess Medical Center

Boston, Massachusetts, United States

Site Status

Countries

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United States

References

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Chalkias S, Dang X, Bord E, Stein MC, Kinkel RP, Sloane JA, Donnelly M, Ionete C, Houtchens MK, Buckle GJ, Batson S, Koralnik IJ. JC virus reactivation during prolonged natalizumab monotherapy for multiple sclerosis. Ann Neurol. 2014 Jun;75(6):925-34. doi: 10.1002/ana.24148. Epub 2014 Jun 10.

Reference Type RESULT
PMID: 24687904 (View on PubMed)

Other Identifiers

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2010P-000249 RG 452 3-A-1

Identifier Type: -

Identifier Source: org_study_id