Treatment switching
Scenario 7
A 43-year-old patient with highly active MS who has been treated with natalizumab for 6 years (no previous immunosuppressants) tests positive for anti-JCV antibodies, with a low index of 0.8. Previous antibody tests had been negative. The patient has not had a clinical relapse for >3 years, and there have been no MRI changes for >2 years.