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Calculated risk of natalizumab-related PML according to currently known risk factors

	Prior immunosuppressant use?	Risk up to 24 months of natalizumab exposure	Risk after 24 months of natalizumab exposure
JC virus antibody negative	No	∼0.02/1000	∼0.2/1000
JC virus antibody negative	Yes	∼0.06/1000	∼0.9/1000
		Risk up to 24 months of natalizumab exposure	Risk during 25 to 48 months of natalizumab exposure	Risk during 49 to 72 months of natalizumab exposure
JC virus antibody positive	No, anti-JCV antibody index not available	∼1/1000	∼3/1000	∼6/1000
	No; anti-JCV antibody index ≤1.5	∼0.2/1000	∼1.1/1000	∼1.4/1000
	No; anti-JCV antibody index >1.5	∼1.2/1000	∼8.8/1000	∼10.1/1000
	Yes	∼6/1000	∼12/1000	∼13/1000

JCV: JC virus; PML: progressive multifocal leukoencephalopathy.

Data from:

Berger JR, Fox RJ. Reassessing the risk of natalizumab-associated PML. J Neurovirol 2016.
Kuesters G, Plavina T, Lee S, et al. Anti-JC virus (JCV) antibody index differentiates risk of progressive multifocal leukoencephalopathy (PML) in natalizumab-treated multiple sclerosis (MS) patients with no prior immunosuppressant (IS) use: An updated analysis. Poster presentation, 67th American Academy of Neurology Annual Meeting, April 22, 2015 Washington DC, USA. www.abstracts2view.com/aan/view.php?nu=AAN15L1_P4.031 (Accessed on February 04, 2016).
Plavina T, Subramanyam M, Bloomgren G, et al. Anti-JC virus antibody levels in serum or plasma further define risk of natalizumab-associated progressive multifocal leukoencephalopathy. Ann Neurol 2014; 76:802.
Fox RJ, Rudick RA. Risk stratification and patient counseling for natalizumab in multiple sclerosis. Neurology 2012; 78:436.

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