Contributions
Abstract: EP1789
Type: ePoster
Abstract Category: Therapy - disease modifying - 32 Others
Background and aims: An increase in the incidence of progressive multifocal leukoencephalopathy (PML) has been observed in MS patients in recent years. This study investigated the incidence of all PML diagnoses and patient characteristics in Sweden between 1988 and 2013.
Methods: All PML diagnoses in Sweden between 1988 and 2013 were identified in the National Patient Register. Information to validate the diagnosis and patient characteristics was obtained from medical records.
Results: Medical record review classified 108 out of 250 patients (43%) as definite (n=84), probable (n=4) or possible (n=20) PML according to diagnostic criteria. Accurate diagnoses were more common in records obtained from neurology departments (82% of patients who were assessed by neurology departments) compared with other departments (33%) (p<0.001). The incidence of PML increased from a largely stable level at 0.026 (95% CI: 0.021-0.031) per 100.000 individuals per year during 1988 - 2010 to 0.11 (0.083-0.137) during 2011- 2013 (p<0.001). Haematological malignancies (n=34), HIV/AIDS (n=33) and autoimmune disease (n=23) were the most common underlying diseases. Treatment with a monoclonal antibody prior to PML diagnosis was identified in 26 patients.
Conclusion: An increased incidence of PML in Sweden was observed and coincided with the prior use of monoclonal antibody treatment. The high level of misdiagnosis emphasises the importance of immediate contact with a neurology centre upon suspicion of PML.
Disclosure: This study was funded predominantly by F. Hoffmann - La Roche Ltd. Additional funding was received from the Stockholm County Council, Swedish Medical Research Council, The Swedish Brain Foundation and Karolinska Institutet.
Ellen Iacobaeus has nothing do disclose, Sarah Burkill has nothing to disclose.
Shahram Bahmanyar has received funding for MS-related research from F. Hoffman-La Roche, Novartis International AG, and AstraZeneca
Ramil Hakim has nothing to disclose, Camilla Byström has nothing to disclose
Michael Fored has nothing to disclose.
Tomas Olsson has received unrestricted MS research grants, speaker or advisory board honoraria from Biogen, Novartis and Genzyme
Lou Brundin has received honoraria for advisory boards for Biogen, Sanofi-Genzyme, Novartis, and Teva, and has received lecturing fees from Biogen, Novartis, Teva and Sanofi-Genzyme.
Scott Montgomery has received funding for MS-related research from F. Hoffman-La Roche, Novartis International AG, and AstraZeneca, as well as honoraria for serving on an advisory board for IMS Health.
Abstract: EP1789
Type: ePoster
Abstract Category: Therapy - disease modifying - 32 Others
Background and aims: An increase in the incidence of progressive multifocal leukoencephalopathy (PML) has been observed in MS patients in recent years. This study investigated the incidence of all PML diagnoses and patient characteristics in Sweden between 1988 and 2013.
Methods: All PML diagnoses in Sweden between 1988 and 2013 were identified in the National Patient Register. Information to validate the diagnosis and patient characteristics was obtained from medical records.
Results: Medical record review classified 108 out of 250 patients (43%) as definite (n=84), probable (n=4) or possible (n=20) PML according to diagnostic criteria. Accurate diagnoses were more common in records obtained from neurology departments (82% of patients who were assessed by neurology departments) compared with other departments (33%) (p<0.001). The incidence of PML increased from a largely stable level at 0.026 (95% CI: 0.021-0.031) per 100.000 individuals per year during 1988 - 2010 to 0.11 (0.083-0.137) during 2011- 2013 (p<0.001). Haematological malignancies (n=34), HIV/AIDS (n=33) and autoimmune disease (n=23) were the most common underlying diseases. Treatment with a monoclonal antibody prior to PML diagnosis was identified in 26 patients.
Conclusion: An increased incidence of PML in Sweden was observed and coincided with the prior use of monoclonal antibody treatment. The high level of misdiagnosis emphasises the importance of immediate contact with a neurology centre upon suspicion of PML.
Disclosure: This study was funded predominantly by F. Hoffmann - La Roche Ltd. Additional funding was received from the Stockholm County Council, Swedish Medical Research Council, The Swedish Brain Foundation and Karolinska Institutet.
Ellen Iacobaeus has nothing do disclose, Sarah Burkill has nothing to disclose.
Shahram Bahmanyar has received funding for MS-related research from F. Hoffman-La Roche, Novartis International AG, and AstraZeneca
Ramil Hakim has nothing to disclose, Camilla Byström has nothing to disclose
Michael Fored has nothing to disclose.
Tomas Olsson has received unrestricted MS research grants, speaker or advisory board honoraria from Biogen, Novartis and Genzyme
Lou Brundin has received honoraria for advisory boards for Biogen, Sanofi-Genzyme, Novartis, and Teva, and has received lecturing fees from Biogen, Novartis, Teva and Sanofi-Genzyme.
Scott Montgomery has received funding for MS-related research from F. Hoffman-La Roche, Novartis International AG, and AstraZeneca, as well as honoraria for serving on an advisory board for IMS Health.