We use cookies to understand how you use our site and to improve your experience. This includes personalizing content and advertising. To learn more, click here. By continuing to use our site, you accept our use of cookies. Cookie Policy.

Features Partner Sites Information LinkXpress
Sign In
Advertise with Us
LGC Clinical Diagnostics

Download Mobile App




Simple Genetic Test Identifies Patients Vulnerable to Severe Side Effect of MS Drugs

By LabMedica International staff writers
Posted on 14 Sep 2023
Print article
Image: A simple genetic test can determine who has a 10-fold higher risk for developing PML (Photo courtesy of Shutterstock)
Image: A simple genetic test can determine who has a 10-fold higher risk for developing PML (Photo courtesy of Shutterstock)

Several medications prescribed for conditions ranging from multiple sclerosis and blood cancers to rheumatoid arthritis have been associated with a rare but often deadly neurological disorder known as progressive multifocal leukoencephalopathy (PML). PML destroys the cells responsible for creating myelin, the protective substance surrounding nerve cells in the brain. It's triggered by a virus present in as many as 85% of adults but only becomes active when the immune system is significantly weakened. Now, a simple genetic test makes it possible to identify individuals at a tenfold higher risk of developing PML, allowing them to consider safer treatment alternatives.

Researchers from Population Bio, Inc. (New York, NY, USA) conducted the most extensive study so far to examine the relationship between medications that heighten PML risk and specific genetic predispositions. They analyzed data from the Food and Drug Administration Adverse Event Reporting System (FAERS) and identified 81 drugs, along with another 18 from the same drug class not reported to FAERS, that are linked to the development of PML. A majority of these drugs are used as immunosuppressant disease-modifying therapies. The researchers evaluated whether these medications mentioned the risk of PML on their labels, either as a Serious Adverse Event (SAE) or featuring a Boxed Warning, the FDA's most severe label caution. They noted that the majority of PML cases are associated with two drugs, natalizumab (used for MS) and rituximab (used for cancer and rheumatoid arthritis), both of which carry a Boxed Warning. Surprisingly, they discovered that two commonly used blood cancer drugs, daratumumab and venetoclax, have no PML risk warning on their labels.

The researchers found that recently-identified genetic variants in four specific genes (C8B, FCN2, LY9 and STXBP2) increased an individual's susceptibility to PML by tenfold if they are taking one of these high-risk medications. These genetic variants are critical players in immune functions and disorders that activate the JC virus, which is dormant in most people. If the JC virus becomes active in someone with a weakened immune system, it can lead to PML. A free genetic test is now available for patients contemplating the use of such medications. If they possess one of these genetic variants, alternative treatment options that do not carry a PML risk should be considered, according to the team.

“The increased risk of drug-induced PML in patients testing positive is higher than already-known genetic associations that are used to guide treatments, like BRCA1/2 for breast cancer, yet many neurologists and oncologists may have limited awareness of how many drugs have been linked to PML,” said Peggy S. Eis, PhD, lead author of the study and chief technology officer at Population Bio, Inc. “There are no treatments to cure PML, so prevention is the best defense, including knowing your genetic risk. Even though the chance of developing PML is very low for some of these drugs, patients should still be screened given the ease and low cost of doing so relative to the avoidable potential consequences for those who do test positive. Clearly, warning labels on some of these drugs need to be updated and can now include a requirement for genetic testing before these drugs are prescribed.”

Related Links:
Population Bio, Inc. 

Platinum Supplier
Xylazine Immunoassay Test
Xylazine ELISA
New
Gold Supplier
Melanoma Panel
UltraSEEK Melanoma Panel
New
CK-MB Rapid Test Cassette (Whole Blood/ Serum/ Plasma)
CK-MB Rapid Test
New
Immunoblots
AESKUBLOT

Print article
GLOBETECH PUBLISHING LLC

Channels

Clinical Chemistry

view channel
Image: The new assays are designed to run on the B•R•A•H•M•S KRYPTOR compact PLUS clinical chemistry analyzer (Photo courtesy of Thermo Fisher)

Breakthrough Immunoassays to Aid in Risk Assessment of Preeclampsia

Preeclampsia is a life-threatening blood pressure condition that can arise during pregnancy and the postpartum phase. This severe pregnancy complication is a primary cause of maternal and fetal mortality... Read more

Hematology

view channel
Image: The latest FDA clearance has finally brought HemoScreen to its full potential as a true POC hematology analyzer (Photo courtesy of PixCell)

True POC Hematology Analyzer with Direct Capillary Sampling Enhances Ease-of-Use and Testing Throughput

An innovative 5-part differential Complete Blood Count (CBC) analyzer with direct capillary sampling capability significantly simplifies blood sampling and minimizes the pre-analytical process.... Read more

Immunology

view channel
Image: A new test could detect the body’s adaptive immune response to viruses (Photo courtesy of 123RF)

Predictive T-Cell Test Detects Immune Response to Viruses Even Before Antibodies Form

The adaptive immune system is an incredible defense mechanism that allows the human body to identify and mount targeted responses against specific pathogens. T-Cells, a special kind of white blood cell,... Read more

Microbiology

view channel
Image: On-chip pretreatment and rapid AST based directly on positive blood cultures (Photo courtesy of Liu Yang)

Integrated Solution for Rapid AST Directly From Positive Blood Cultures to Combat Bloodstream Infection

The presence of living bacteria in the bloodstream, known as bacteremia, can lead to serious conditions like bloodstream infections (BSIs) and sepsis, which can often be fatal. Quickly prescribing the... Read more

Pathology

view channel
Image: A new microscopy method detects treatment-resistant cancer cells early (Photo courtesy of 123RF)

New Rapid-Live Screening Microscopy Technique Enables Early Detection of Treatment-Resistant Cancer Cells

Chemotherapy serves as an effective tool in the fight against cancer, yet some cancer cells can evade treatment by going into a dormant state known as senescence. These so-called therapy-induced senescent... Read more

Technology

view channel
Image: A new electrochemical device can quickly and inexpensively identify people at greatest risk for osteoporosis (Photo courtesy of ACS Central Science, 2023)

Electrochemical Device Identifies People at Higher Risk for Osteoporosis Using Single Blood Drop

With the global increase in life expectancy, the incidence of age-related conditions like osteoporosis is increasing. Osteoporosis, affecting around 200 million individuals worldwide, has a higher incidence... Read more

Industry

view channel
Image: AACC Middle East is a two-day conference that brings the latest in laboratory medicine to the Middle East region (Photo courtesy of ADLM)

AACC Middle East 2023 to Explore Latest Trends in Clinical Pathology and Laboratory Medicine

The AACC Middle East Conference and Exposition will be held by the Association for Diagnostics & Laboratory Medicine (ADLM - formerly AACC, Washington, DC, USA) in partnership with Life Dx (Abu Dhabi,... Read more
Copyright © 2000-2023 Globetech Media. All rights reserved.