進行性多巣性白質脳症の現況

Progressive Multifocal Leukoencephalopathy: An Overview of Current Topics

進行性多巣性白質脳症（progressive multifocal leukoencephalopathy：PML）の概説と薬剤関連PML，特に多発性硬化症（multiple sclerosis：MS）の疾患修飾薬（disease-modifying drug：DMD）関連PMLの現状を概説した。ナタリズマブ，フィンゴリモド，フマル酸ジメチル関連PMLの現状と，シポニモドとオファツムマブでの発症可能性を論じた。PML診療はDMD関連PMLに対応する時代であり，MSでは特に重要である。PMLに特異的な治療薬はないが，治療の可能性が報告されている最近の薬剤も紹介した。

Abstract

Here, an overview of progressive multifocal leukoencephalopathy (PML) and its drug associations, especially the disease-modifying drug (DMD)-associated PML for multiple sclerosis (MS) were discussed. Additionally, along with presenting the current status of PML in MS caused by natalizumab, fingolimod, and dimethyl fumarate, the possibility of PML onset with siponimod and ofatumumab, the two newly proposed DMDs for MS, was provided. PML treatment in the era of DMD-associated PML, especially PML in MS, is an important issue. With respect to the treatment of PML, to date, there are no specific antiviral drugs against the JC virus; some drugs, that may have therapeutic potential reported recently, were also mentioned.