Contributions
Abstract: P931
Type: Poster Sessions
Abstract Category: Therapy - Risk management for disease modifying treatments
Introduction: Dimethyl fumarate (DMF) is an approved drug to treat relapsing-remitting multiple sclerosis (RRMS) which causes lymphopenia.
Aims: The objective of this study was to investigate risk factors for DMF-induced lymphopenia.
Methods: We performed a retrospective study of all RRMS patients, who started treatment with DMF, at the MS Centre of Montichiari (Brescia, Italy) from January 2015 to February 2018. Patients were divided into two groups: group 1 with lymphopenia defined as lymphocyte count less than 0.8 109/L and group 2 with normal lymphocyte count. A multivariate logistic regression analysis was performed to identify the predictors associated with lymphopenia, while a survival analysis was conducted to identify the different impact of age. Age at DMF start was divided between the following intervals: < 30, 30-40, 40-50, and > 50 years.
Results: 147 patients (F: 68%) with a mean age of 40.0±10.6 and with a mean disease duration of 8.16±8.0 years were included. The two groups of patients differed by age, DMF treatment duration, EDSS score and baseline absolute lymphocyte count (ALC) (all p< 0.05). There was no statistical difference between the two groups regarding sex and prior use of other disease modifying therapies. Older age (OR:1.09; p=0.003), longer treatment duration (OR: 1.07; p=0.004) and lower baseline ALC (OR:0.99; p=0.017) increased the risk of becoming lymphopenic. The survival analysis revealed that patients older than 50 years developed lymphopenia after 15.5 months, 40-50 after 27.1months, 30-40 after 29.8 months and < 30 after 34.3 months. The difference between the four age groups was statistically significant, χ2(3) = 26.183, p < 0.0005.
Conclusions: our study suggests that older age at DMF start may represent a risk factor for early lymphopenia. Immunosenescence could have a role in a reduced lymphopoiesis exacerbated by DMF, especially in patients with lower baseline ALC and longer treatment.
Disclosure: Dr. De Rossi received speaker honoraria from Biogen and Teva and travel grants from Biogen, Teva and Merk Serono. Dr. Cordioli received consulting fees from Novartis, TEVA and Merk-Serono.Dr. Capra received consulting fees from Novartis, Biogen-Idec and lecture fees and/or travel grants from Novartis, Biogen-Idec, Teva, Genzyme and Sanofi-Aventis. Dr. Scarpazza, Dr. Rasia and Dr. Mancinelli have nothing to disclose
Abstract: P931
Type: Poster Sessions
Abstract Category: Therapy - Risk management for disease modifying treatments
Introduction: Dimethyl fumarate (DMF) is an approved drug to treat relapsing-remitting multiple sclerosis (RRMS) which causes lymphopenia.
Aims: The objective of this study was to investigate risk factors for DMF-induced lymphopenia.
Methods: We performed a retrospective study of all RRMS patients, who started treatment with DMF, at the MS Centre of Montichiari (Brescia, Italy) from January 2015 to February 2018. Patients were divided into two groups: group 1 with lymphopenia defined as lymphocyte count less than 0.8 109/L and group 2 with normal lymphocyte count. A multivariate logistic regression analysis was performed to identify the predictors associated with lymphopenia, while a survival analysis was conducted to identify the different impact of age. Age at DMF start was divided between the following intervals: < 30, 30-40, 40-50, and > 50 years.
Results: 147 patients (F: 68%) with a mean age of 40.0±10.6 and with a mean disease duration of 8.16±8.0 years were included. The two groups of patients differed by age, DMF treatment duration, EDSS score and baseline absolute lymphocyte count (ALC) (all p< 0.05). There was no statistical difference between the two groups regarding sex and prior use of other disease modifying therapies. Older age (OR:1.09; p=0.003), longer treatment duration (OR: 1.07; p=0.004) and lower baseline ALC (OR:0.99; p=0.017) increased the risk of becoming lymphopenic. The survival analysis revealed that patients older than 50 years developed lymphopenia after 15.5 months, 40-50 after 27.1months, 30-40 after 29.8 months and < 30 after 34.3 months. The difference between the four age groups was statistically significant, χ2(3) = 26.183, p < 0.0005.
Conclusions: our study suggests that older age at DMF start may represent a risk factor for early lymphopenia. Immunosenescence could have a role in a reduced lymphopoiesis exacerbated by DMF, especially in patients with lower baseline ALC and longer treatment.
Disclosure: Dr. De Rossi received speaker honoraria from Biogen and Teva and travel grants from Biogen, Teva and Merk Serono. Dr. Cordioli received consulting fees from Novartis, TEVA and Merk-Serono.Dr. Capra received consulting fees from Novartis, Biogen-Idec and lecture fees and/or travel grants from Novartis, Biogen-Idec, Teva, Genzyme and Sanofi-Aventis. Dr. Scarpazza, Dr. Rasia and Dr. Mancinelli have nothing to disclose