Editors' note: Progressive multifocal leukoencephalopathy after fingolimod treatment

Berger et al. queried the Novartis safety database to describe the epidemiology of progressive multifocal leukoencephalopathy (PML) among fingolimod users; with only 15 cases reported to date, the investigators estimated an incidence rate of approximately 3 per 100,000 person-years (3 orders of magnitude lower than what has been seen with natalizumab use). While the risk of PML should be considered among users of these immunotherapies—as Drs. Lalive, Roth, and Du Pasquier maintain—other risk factors for the development of PML must also be weighed, such as age and duration of therapy.

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