A 50-year-old has received natalizumab for four years without prior immunosuppression. She has newly positive anti-JCV antibodies with index 0.3 and

Question

A 50-year-old has received natalizumab for four years without prior immunosuppression. She has newly positive anti-JCV antibodies with index 0.3 and wishes to continue after shared decision-making. Which monitoring statement is most accurate?

Accepted Answer

Maintain at least annual MRI surveillance and repeat anti-JCV antibody index at six-month intervals after two years of treatment

Answer

Repeat anti-JCV antibody testing every five years because index values are stable after seroconversion

Answer

Continue natalizumab without documented PML risk discussion if clinical disease activity is absent

Answer

Stop all MRI surveillance because a low anti-JCV index excludes progressive multifocal leukoencephalopathy

Answer

Use anti-JCV antibody testing alone because MRI detects progressive multifocal leukoencephalopathy only after symptoms begin

Natalizumab JCV Seroconversion – Enhanced MRI — SCE Neurology MCQ

A 50-year-old has received natalizumab for four years without prior immunosuppression. She has newly positive anti-JCV antibodies with index 0.3 and wishes to continue after shared decision-making. Which monitoring statement is most accurate?