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Efficacy of alemtuzumab in relapsing-remitting MS patients who received additional courses after the initial two courses: Pooled analysis of the CARE-MS, extension, and TOPAZ studies

Journal article
Authors G. Comi
R. Alroughani
A. L. Boster
A. D. Bass
R. Berkovich
O. Fernandez
H. J. Kim
V. Limmroth
Jan Lycke
R. A. L. Macdonell
B. Sharrack
B. A. Singer
P. Vermersch
H. Wiendl
T. Ziemssen
A. Jacobs
N. Daizadeh
C. E. Rodriguez
A. Traboulsee
Published in Multiple Sclerosis Journal
Pages 11
ISSN 1352-4585
Publication year 2019
Published at Institute of Neuroscience and Physiology
Pages 11
Language en
Links dx.doi.org/10.1177/1352458519888610
Keywords Alemtuzumab, efficacy, multiple sclerosis, relapse, retreatment, safety, multiple-sclerosis, disease-activity, Neurosciences & Neurology
Subject categories Neurology

Abstract

Background: Alemtuzumab is given as two annual courses. Patients with continued disease activity may receive as-needed additional courses. Objective: To evaluate efficacy and safety of additional alemtuzumab courses in the CARE-MS (Comparison of Alemtuzumab and Rebif (R) Efficacy in Multiple Sclerosis) studies and their extensions. Methods: Subgroups were based on the number of additional alemtuzumab courses received. Exclusion criteria: other disease-modifying therapy (DMT); Results: In the additional-courses groups, Courses 3 and 4 reduced annualized relapse rate (12 months before: 0.73 and 0.74, respectively; 12 months after: 0.07 and 0.08). For 36 months after Courses 3 and 4, 89% and 92% of patients were free of 6-month confirmed disability worsening, respectively, with 20% and 26% achieving 6-month confirmed disability improvement. Freedom from magnetic resonance imaging (MRI) disease activity increased after Courses 3 and 4 (12 months before: 43% and 53%, respectively; 12 months after: 73% and 74%). Safety was similar across groups; serious events occurred irrespective of the number of courses. Conclusion: Additional alemtuzumab courses significantly improved outcomes, without increased safety risks, in CARE-MS patients with continued disease activity after Course 2. How this compares to outcomes if treatment is switched to another DMT instead remains unknown.

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