Efficacy and safety of alemtuzumab versus fingolimod in RRMS after natalizumab cessation

Beitrag in einer Fachzeitschrift


Details zur Publikation

Autorinnen und Autoren: Pfeuffer S, Schmidt R, Straeten FA, Pul R, Kleinschnitz C, Wieshuber M, Lee DH, Linker R, Doerck S, Straeten V, Windhagen S, Pawlitzki M, Aufenberg C, Lang M, Eienbroeker C, Tackenberg B, Limmroth V, Wildemann B, Haas J, Klotz L, Wiendl H, Ruck T, Meuth SG
Zeitschrift: Journal of Neurology
Jahr der Veröffentlichung: 2019
Band: 266
Heftnummer: 1
Seitenbereich: 165-173
ISSN: 0340-5354


Abstract

Background: Natalizumab (NTZ) was the first approved monoclonal antibody for the treatment of relapsing-remitting multiple sclerosis (RRMS). Despite proven and sustained efficacy, its use is limited by the risk of progressive multifocal leukoencephalopathy (PML). Moreover, some patients show ongoing disease activity under NTZ, requiring a switch to another disease-modifying treatment (DMT). However, evidence regarding the optimal DMT for treatment of active RRMS after NTZ-cessation is still scarce. Objective: To evaluate efficacy and safety outcomes of ALEM vs FTY treatment after cessation of NTZ. Methods: We retrospectively identified patients at 12 German neurology centers and analyzed risks for disease activity, adverse events, disability progression, and treatment discontinuation. Results: 195 patients were identified and 144 underwent final analysis (FTY: 101; ALEM: 42). The hazard ratio for clinical relapses was 2.24 favoring ALEM (95% CI 1.12–4.50; p = 0.015). The hazard ratio for adverse events was 7.78 (95% CI 1.04–57.95; p = 0.006) and 2.41 for MRI progression (95% CI 1.26–4.60; p = 0.004). The odds ratio for disability progression after 12 months was 4.84 (95% CI 1.74–13.47, p = 0.003). Differences remained after adjusting for possible confounders (e.g., age, sex, baseline disability, NTZ treatment duration, washout time). Conclusion: Our findings indicated particular advantages of ALEM compared to FTY in patients stopping NTZ.


FAU-Autorinnen und Autoren / FAU-Herausgeberinnen und Herausgeber

Lee, De-Hyung PD Dr.
Medizinische Fakultät
Linker, Ralf PD Dr.
Neurologische Klinik


Einrichtungen weiterer Autorinnen und Autoren

Herz-Jesu-Krankenhaus Hiltrup GmbH
Johannes Wesling Klinikum Minden
Julius-Maximilians-Universität Würzburg
Klinikum Osnabrück
Universität Duisburg-Essen (UDE)
Universität Köln
Universitätsklinikum Gießen und Marburg (UKGM)
Universitätsklinikum Heidelberg
Universitätsklinikum Magdeburg A.ö.R.
Westfälische Wilhelms-Universität (WWU) Münster


Zitierweisen

APA:
Pfeuffer, S., Schmidt, R., Straeten, F.A., Pul, R., Kleinschnitz, C., Wieshuber, M.,... Meuth, S.G. (2019). Efficacy and safety of alemtuzumab versus fingolimod in RRMS after natalizumab cessation. Journal of Neurology, 266(1), 165-173. https://dx.doi.org/10.1007/s00415-018-9117-z

MLA:
Pfeuffer, Steffen, et al. "Efficacy and safety of alemtuzumab versus fingolimod in RRMS after natalizumab cessation." Journal of Neurology 266.1 (2019): 165-173.

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Zuletzt aktualisiert 2019-03-06 um 10:08