A combination of an anti-viral therapy and the anti-depressive mirtazapine can stop the worsening of an infection linked to the multiple sclerosis therapy Tysabri (natalizumab), a case study suggests.
The infection, John Cunninghan polyomavirus, can cause a potentially fatal brain infection known as progressive multifocal leukoencephalopathy, or PML. Both infections are caused by viruses.
Early treatment with mirtazapine and either IV-administered Vistide (cidofovir) or its oral formulation, brincidofovir, helped protect the nerve cells of four people with MS and Tysabri-associated PML, the case study showed.
Researchers presented the findings at the Third Annual Americas Committee for Treatment and Research in Multiple Sclerosis Forum 2018 in San Diego, Feb. 1-3. The poster presentation was titled “Treatment of Natalizumab-Induced PML with Cidofovir or CMX001 (brincidofovir) and Mirtazapine.”
Previous studies had shown that the Vistide-mirtazapine combo helped patients with a compromised immune system who developed PML. Vistide is marketed by Gilead Sciences in the U.S., and by Pfizer elsewhere. Mirtazapine is sold under several brand names.
The combo also helped people with autoimmune diseases, such as systemic lupus erythematosus, studies demonstrated. An autoimmune disease is one in which the immune system attacks healthy tissue instead of invaders.
Until the case study, there was no evidence that the combo would help MS patients with therapy-associated PML.
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