RT Journal Article
SR Electronic
T1 Effects of Alemtuzumab on Disability and Cognition in Patients with Secondary Progressive Multiple Sclerosis (SPMS) (P5.356)
JF Neurology
JO Neurology
FD Lippincott Williams & Wilkins
SP P5.356
VO 88
IS 16 Supplement
A1 Berkovich, Regina
YR 2017
UL http://n.neurology.org/content/88/16_Supplement/P5.356.abstract
AB Objective: Evaluate the effectiveness and safety of alemtuzumab in patients with SPMS.Background: Alemtuzumab is a humanized monoclonal antibody that selectively targets CD52, resulting in depletion and subsequent distinct repopulation of circulating T and B lymphocytes. In RRMS patients with active disease, alemtuzumab showed durable efficacy on clinical and MRI outcomes and slowed brain volume loss through 6 years despite absence of continuous treatment in the majority of patients. However, there is very limited data on the use of alemtuzumab in SPMS patients. The Cambridge Cohort study showed alemtuzumab reduced relapses and slowed disability accumulation in SPMS patients.Design/Methods: Real-world prospective analysis of treatment-resistant SPMS patients who were treated with alemtuzumab. Outcomes measures included baseline and 6-month post-treatment relapses, EDSS, timed 25-foot walk (T25FW), Montreal Cognitive Assessment (MoCA) test, and side effects.Results: A total of 15 patients were included in this analysis, with a mean age of 46.7 ± 8.3 years, disease duration of 15.6 ± 5.1 years, baseline EDSS of 7.0 ± 0.9, T25FW of 18.0 ± 12.6 seconds (N=11), and MoCA score of 24.1 ± 3.3. In the 2 years pre-alemtuzumab, 14 patients had 1 relapse and 1 patient had 2 relapses. Prior treatments included natalizumab (N=9), teriflunomide (N=2), dimethyl fumarate (N=2), rituximab (N=1), and PLEX (N=1). Six month follow-up showed EDSS improved by 0.5 ± 0.4 point (p=0.0004), T25FW improved by 36% or 6.4 ± 8.5 seconds (p=0.097), and MoCA score improved by 2.6 ± 2.6 (p=0.0018). One patient experienced a relapse. Three of the four patients with baseline internuclear ophthalmoplegia experienced improvement. Side effects included mild infusion reactions (N=1), transient platelet lowering (N=1), and mild fatigue lasting 2–4 weeks post-infusion (N=8).Conclusions: The positive results on disability and cognition suggest that alemtuzumab may provide a treatment option for SPMS patients. Additional larger scale studies are needed.Study Supported by: Not applicableDisclosure: Dr. Berkovich has received personal compensation for activities with Acorda, Avanir, Bayer, Biogen, Sanofi Genzyme, Novartis, Questcor, and Teva Neuroscience as an Advisory Board Member and a consultant.