Progressive multifocal
leukoencephalopathy (PML)

June 2007     View PDF     En español

Experimental treatments

Cidofovir: Several studies of the anti-CMV drug, cidofovir, first looked encouraging for treating PML. However, over time these studies failed to show any benefit and so it is no longer recommended for treating PML.

Corticosteroids: There is some debate about adding corticosteroids to potent anti-HIV therapy for treating PML. Those opposed to using them say they may further weaken the immune system, which is critical in successfully treating PML. There are also a few cases where the development of PML has been associated with their use. Those in favor of using corticosteroids note that increased inflammation associated with using anti-HIV therapy may be quieted by using these steroids and thus aid PML recovery. Currently, experts are interested in studying corticosteroids as an added therapy to potent anti-HIV therapy for PML.

Interferon Therapy: Researchers have been interested in using both Interferon-alpha and Interferon-beta to treat PML. In test tube studies, both are active against the JC virus. However, studies in people with PML have been terribly underwhelming. Researchers feel that if there were better ways to target the therapy to the brain lesions and the virus, it may be worth revisiting the research on these therapies.

5HT2a Antagonists: This includes drugs like Remeron (mirtazapine)—a drug usually used to treat depression—and other similar drugs. Some speculate that this class of drugs might be useful in treating PML. Experts have gathered anecdotal information as they ponder further research. Their first reaction to the anecdotes is that they are not terribly impressive. Even still, when added to anti-HIV therapy, this class may provide a new therapy.

Other Possible Interventions: for study include interleukin-2 (IL-2), topoisomerase inhibitors (topotecan, camptothecan, etc.), adoptive cell therapy (enhancing JC virus specific cellular immunity) and RNAsi.
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