Contributions
Abstract: EP1625
Type: Poster Sessions
Abstract Category: Therapy - Neuroprotection and Repair
Background: With the increased use of high dose biotin in the treatment of progressive multiple sclerosis (MS) following the MS-SPI study in 2016, case series describe potential pro-inflammatory effect following its initiation. Its specific imputation remains not yet determined.
Objective: To describe in real-life conditions characteristics of relapses during the treatment with high dose biotin and try to identify any associated parameters.
Methods: We conducted a prospective monocentric observational study by collecting demographical and clinical data of multiple sclerosis patients treated with high dose biotin (300 mg/day) from September 2015 to February 2018. In case of relapse event, MRI evaluation was realized before prednisolone therapy.
Results: A hundred and seven progressive MS patients treated with high dose biotin for at least 3 months were included in our study. Five patients (4.67%) presented a relapse following well-conducted treatment in the 8 to 11 months after initiation. These patients were relapse-free for the 5 previous years, without inflammatory activity documented by MRI available in 4 out 5 patients. These consisted of 3 women and 2 men, 1 primary progressive and 4 secondary progressive, aged 51 to 60 (mean 54.8) with a disease duration of 9 to 28 years (mean 18.2) and baseline EDSS of 3.5 to 6.5 (median 5.6). None of the patients had had recent disease modifying therapy change. Inflammatory activity was radiologically documented with new MRI T2 and gadolinium-enhancing brain lesions in all 5 patients. No factor was associated with the risk of relapse in an univariate analysis. Relapses were considered as a side effect of treatment and biotin was discontinued in 4 out of 5 patients. Two patients fully recovered and 3 patients had a worsening of EDSS of 0.5, 1 and 2.5. Anti-CD20 therapy was started in all patients with this new inflammatory activity.
Conclusion: Our study found a ratio of 4.67% of relapses in a progressive multiple sclerosis population without previous inflammatory activity. If pro-inflammatory effect of high dose biotin is to be confirmed, future research will be warranted to identify a specific patient profile at risk.
Disclosure: Pr. Brochet or its institution received honoraria for consulting, speaking at scientific symposia, serving in advisory board or research support from Actelion, Biogen Idec, Merck Serono, Sanofi-Genzyme, Bayer, Medday, Roche, Teva, Novartis (all with approval by general director of the Hospital of Bordeaux).
Dr. Ouallet reported personal fees from Biogen, Roche, Genzyme; grants, personal fees and non-financial support from Novartis and Merck, outside the submitted work.
Dr. Dulau received honoraria for speaking at scientific symposia by Biogen, Genzyme, Novartis and Teva.
Dr. Ruet or her institution received honoraria for consulting, speaking at scientific symposia, serving in advisory board or research support from Biogen Idec, Medday, Merck Serono, Novartis, Roche, Sanofi-Genzyme, Teva (all with approval by general director of the Hospital of Bordeaux and the University of Bordeaux).
Drs. Liegey, Deloire, Moroso, Louiset and Guerard : nothing to disclose.
Abstract: EP1625
Type: Poster Sessions
Abstract Category: Therapy - Neuroprotection and Repair
Background: With the increased use of high dose biotin in the treatment of progressive multiple sclerosis (MS) following the MS-SPI study in 2016, case series describe potential pro-inflammatory effect following its initiation. Its specific imputation remains not yet determined.
Objective: To describe in real-life conditions characteristics of relapses during the treatment with high dose biotin and try to identify any associated parameters.
Methods: We conducted a prospective monocentric observational study by collecting demographical and clinical data of multiple sclerosis patients treated with high dose biotin (300 mg/day) from September 2015 to February 2018. In case of relapse event, MRI evaluation was realized before prednisolone therapy.
Results: A hundred and seven progressive MS patients treated with high dose biotin for at least 3 months were included in our study. Five patients (4.67%) presented a relapse following well-conducted treatment in the 8 to 11 months after initiation. These patients were relapse-free for the 5 previous years, without inflammatory activity documented by MRI available in 4 out 5 patients. These consisted of 3 women and 2 men, 1 primary progressive and 4 secondary progressive, aged 51 to 60 (mean 54.8) with a disease duration of 9 to 28 years (mean 18.2) and baseline EDSS of 3.5 to 6.5 (median 5.6). None of the patients had had recent disease modifying therapy change. Inflammatory activity was radiologically documented with new MRI T2 and gadolinium-enhancing brain lesions in all 5 patients. No factor was associated with the risk of relapse in an univariate analysis. Relapses were considered as a side effect of treatment and biotin was discontinued in 4 out of 5 patients. Two patients fully recovered and 3 patients had a worsening of EDSS of 0.5, 1 and 2.5. Anti-CD20 therapy was started in all patients with this new inflammatory activity.
Conclusion: Our study found a ratio of 4.67% of relapses in a progressive multiple sclerosis population without previous inflammatory activity. If pro-inflammatory effect of high dose biotin is to be confirmed, future research will be warranted to identify a specific patient profile at risk.
Disclosure: Pr. Brochet or its institution received honoraria for consulting, speaking at scientific symposia, serving in advisory board or research support from Actelion, Biogen Idec, Merck Serono, Sanofi-Genzyme, Bayer, Medday, Roche, Teva, Novartis (all with approval by general director of the Hospital of Bordeaux).
Dr. Ouallet reported personal fees from Biogen, Roche, Genzyme; grants, personal fees and non-financial support from Novartis and Merck, outside the submitted work.
Dr. Dulau received honoraria for speaking at scientific symposia by Biogen, Genzyme, Novartis and Teva.
Dr. Ruet or her institution received honoraria for consulting, speaking at scientific symposia, serving in advisory board or research support from Biogen Idec, Medday, Merck Serono, Novartis, Roche, Sanofi-Genzyme, Teva (all with approval by general director of the Hospital of Bordeaux and the University of Bordeaux).
Drs. Liegey, Deloire, Moroso, Louiset and Guerard : nothing to disclose.