Table 1 MAGNIMS consensus guideline: regimens for risk-based MRI monitoring in MS patients treated with natalizumab [24]
Population | Recommended MRI regimen | Interval |
|---|---|---|
Natalizumab-treated patients at high risk of PML (ie, anti-JCV seropositive AND treatment duration ≥18 months) | • Conventional T2-weighted imaging • T2-FLAIR • DWI • Contrast-enhanced T1-weighted imaging [in patients with suspected PML lesions] | • Every 3–4 months |
Natalizumab-treated patients at low risk of PML (i.e., anti-JCV seronegative) | • Conventional T2-weighted imaging • T2-FLAIR • DWI | • Every 12 months |
Patients who switch from natalizumab to other drugs (including fingolimod, alemtuzumab, dimethyl fumarate) | • Conventional T2-weighted imaging • Contrast-enhanced T1-weighted imaging | • Every 3–4 months, for up to 12 months |
Patients at high risk of developing opportunistic infections who are switching immunotherapies | • Conventional T2-weighted Imaging • Contrast-enhanced T1-weighted imaging • T2-FLAIR • DWI • Contrast-enhanced T1-weighted imaging [in patients with suspected PML lesions] | • At end of ongoing therapy • After starting therapy with the next drug |