Risk Acceptance in Multiple Sclerosis Patients on Natalizumab Treatment

• Autor(a) principal: Tur, Carmen
• Data de Publicação: 2013
• Outros Autores: Tintore, Mar, Vidal-Jordana, Angela, Bichuetti, Denis [UNIFESP], Nieto Gonzalez, Pablo, Jesus Arevalo, Maria, Arrambide, Georgina, Anglada, Elisenda, Galan, Ingrid, Castillo, Joaquin, Jordi Rio, Carlos Nos, Isabel Martin, Maria, Comabella, Manuel, Sastre-Garriga, Jaume, Montalban, Xavier
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UNIFESP
• dARK ID: ark:/48912/001300000cm3x
• Texto Completo: http://dx.doi.org/10.1371/journal.pone.0082796; http://repositorio.unifesp.br/handle/11600/37076

Objective: We aimed to investigate the ability of natalizumab (NTZ)-treated patients to assume treatment-associated risks and the factors involved in such risk acceptance.Methods: From a total of 185 patients, 114 patients on NTZ as of July 2011 carried out a comprehensive survey. We obtained disease severity perception scores, personality traits' scores, and risk-acceptance scores (RAS) so that higher RAS indicated higher risk acceptance. We recorded JC virus status (JCV+/-), prior immunosuppression, NTZ treatment duration, and clinical characteristics. NTZ patients were split into subgroups (A-E), depending on their individual PML risk. Some 22 MS patients on first-line drugs (DMD) acted as controls.Results: No differences between treatment groups were observed in disease severity perception and personality traits. RAS were higher in NTZ than in DMD patients (p<0.01). Perception of the own disease as a more severe condition tended to predict higher RAS (p=0.07). Higher neuroticism scores predicted higher RAS in the NTZ group as a whole (p=0.04), and in high PML-risk subgroups (A-B) (p=0.02). in low PML-risk subgroups (C-E), higher RAS were associated with a JCV+ status (p=0.01). Neither disability scores nor pre-treatment relapse rate predicted RAS in either group.Conclusions: Risk acceptance is a multifactorial phenomenon, which might be partly explained by an adaptive process, in light of the higher risk acceptance amongst NTZ-treated patients and, especially, amongst those who are JCV seropositive but still have low PML risk, but which seems also intimately related to personality traits.