Huhn K, et al. - This trial evaluated the efficacy and safety of alemtuzumab following fingolimod treatment in patients presenting with relapsing–remitting multiple sclerosis (RRMS). Findings revealed the high effectiveness of therapy switch in reducing clinical and MRI surrogates of disease activity. It also appeared to be well tolerated within 1 year of follow-up. It was inferred that alemtuzumab served as a promising therapy in RRMS with refractory disease activity, without regard to fingolimod treatment.

Methods

• This study retrospectively assessed the clinical and MRI data of 50 RRMS patients with a history of switching from fingolimod to alemtuzumab.
• Data acquisition took place from nine large German MS Centers from 2013 to 2016. Data analysis was conducted using descriptive statistics.

Results

• It was reported that patients with disease duration of 12.9 years and median EDSS of 3.0 at baseline switched to alemtuzumab after 68 weeks of fingolimod treatment.
• Subjects on alemtuzumab were then followed for a mean of 64 weeks.
• A decrease was seen in the annualized relapse rate from 2.2 in the previous year to 0.34 in the following year after switching to alemtuzumab and EDSS stabilized.
• MRI data indicated a reduction in enhancing (4.47 vs 0.26) and new/enlarging T2 lesions (5.8 vs 0.27) after treatment adjustment in a subgroup of patients (n = 23).
• Side effects were as expected from published data for alemtuzumab (autoimmunity 2/50, severe infections 1/50).
• Findings exhibited that 1 patient suffered combined lethal necrotizing leukoencephalopathy and hemolytic anemia.