Contributions
Abstract: P572
Type: Poster Sessions
Abstract Category: Therapy - Immunomodulation/Immunosuppression
Background: It has been described that treating relapsing-remitting multiple sclerosis (RRMS) patients with alemtuzumab following fingolimod could be less effective due to the different dynamics of lymphocyte repopulation. Effectiveness and safety of alemtuzumab compared to a cohort of RRMS patients treated with rituximab after fingolimod withdrawal were analysed.
Patients and methods: A prospective follow-up of a cohort of RRMS patients of two MS Units in Valencia (Spain) treated with alemtuzumab or rituximab after fingolimod withdrawal was accomplished. Effectiveness, measured by the percentage of patients with no evidence of disease activity (NEDA), and the presence of side effects were registered.
Results: A total of 55 patients, 28 with alemtuzumab and 27 with rituximab were analysed. No differences in the washout period (median (interquantile range); alemtuzumab: 42 days (21.3-59.5); rituximab: 34 days (17.3-61.3); p=0,49) or in the number or lymphocytes before starting the new treatment (median (interquantile range); alemtuzumab: 1310 (815-1670); rituximab: 1100 (665-1580); p=0,44) were observed. After a mean follow-up period of 28.8 months (SD: 18), the annualized relapsing rate was significantly reduced in the alemtuzumab group from 1.29 to 0.004 (p< 0.001) and in the rituximab group from 1.24 to 0.02 (p< 0.001), without differences between groups. After one year of follow-up, a significant reduction of the median EDSS (interquartile range) from 2.8 (2-3) to 2.0 (1.5-2.5) (p=0.03) in the alemtuzumab group and from 3.5 (2-4) to 2.5 (2-4) (p< 0.01) in the rituximab group were observed; these reductions remained stable after the second year, without statistical differences between both groups. Eighty-two per cent (n=28) of patients in alemtuzumab group and 70% (n=27) in rituximab group achieved NEDA criteria, without differences (p=0.3). Symptoms related to the infusion were the most frequent side effect in both groups. No serious side effects were registered in any group.
Conclusion: Treating RRMS patients with alemtuzumab or rituximab after fingolimod withdrawal is effective and safe, without significantly differences between both groups. Previous treatment with fingolimod did not negatively influence response to alemtuzumab in our series.
Disclosure: We declare not conflict of interest
Abstract: P572
Type: Poster Sessions
Abstract Category: Therapy - Immunomodulation/Immunosuppression
Background: It has been described that treating relapsing-remitting multiple sclerosis (RRMS) patients with alemtuzumab following fingolimod could be less effective due to the different dynamics of lymphocyte repopulation. Effectiveness and safety of alemtuzumab compared to a cohort of RRMS patients treated with rituximab after fingolimod withdrawal were analysed.
Patients and methods: A prospective follow-up of a cohort of RRMS patients of two MS Units in Valencia (Spain) treated with alemtuzumab or rituximab after fingolimod withdrawal was accomplished. Effectiveness, measured by the percentage of patients with no evidence of disease activity (NEDA), and the presence of side effects were registered.
Results: A total of 55 patients, 28 with alemtuzumab and 27 with rituximab were analysed. No differences in the washout period (median (interquantile range); alemtuzumab: 42 days (21.3-59.5); rituximab: 34 days (17.3-61.3); p=0,49) or in the number or lymphocytes before starting the new treatment (median (interquantile range); alemtuzumab: 1310 (815-1670); rituximab: 1100 (665-1580); p=0,44) were observed. After a mean follow-up period of 28.8 months (SD: 18), the annualized relapsing rate was significantly reduced in the alemtuzumab group from 1.29 to 0.004 (p< 0.001) and in the rituximab group from 1.24 to 0.02 (p< 0.001), without differences between groups. After one year of follow-up, a significant reduction of the median EDSS (interquartile range) from 2.8 (2-3) to 2.0 (1.5-2.5) (p=0.03) in the alemtuzumab group and from 3.5 (2-4) to 2.5 (2-4) (p< 0.01) in the rituximab group were observed; these reductions remained stable after the second year, without statistical differences between both groups. Eighty-two per cent (n=28) of patients in alemtuzumab group and 70% (n=27) in rituximab group achieved NEDA criteria, without differences (p=0.3). Symptoms related to the infusion were the most frequent side effect in both groups. No serious side effects were registered in any group.
Conclusion: Treating RRMS patients with alemtuzumab or rituximab after fingolimod withdrawal is effective and safe, without significantly differences between both groups. Previous treatment with fingolimod did not negatively influence response to alemtuzumab in our series.
Disclosure: We declare not conflict of interest