Natalizumab PML Risk — RACP Adult Medicine MCQ

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ModerateNeurologyNatalizumab PML RiskRACP Adult Medicine

A 45-year-old woman with MS on natalizumab for 3 years. JCV antibody index 2.5 (high). 40 monthly infusions. Recommended action?

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Correct answer: E — Switch to alternative DMT due to high PML risk

High JCV index + >24 months treatment = estimated PML risk >10/1000. Switch to alternative high-efficacy DMT.

Reference: eTG – 2025 – Neurology; MS Research Australia – 2023