Switch to Alemtuzumab Reduces MS Disease Activity

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These patients discontinued treatment with interferon beta-1a and initiated treatment with alemtuzumab.
These patients discontinued treatment with interferon beta-1a and initiated treatment with alemtuzumab.

Patients with relapsing remitting multiple sclerosis who received Lemtrada (alemtuzumab; Sanofi Genzyme) after switching from interferon beta-1a experienced reduced disease activity that was maintained over 5 years, according to findings from an extension study that included patients from the CARE-MS I and CARE-MS II trials. The findings were presented at the 7th Joint ECTRIMS-ACTRIMS Meeting in Paris, France.

Approximately 80% of patients from the CARE-MS I trial (n =139) and the CARE-MS II trial (n =143) had elected to enter the extension phase of the study; these patients discontinued treatment with interferon beta-1a and initiated treatment with Lemtrada (first course upon entering extension, second course 12 months later). Results from the extension study included the following:

  • After receiving 2 courses of Lemtrada, 71% of patients from CARE-MS I and 61% of patients from CARE-MS II received no further treatment through year 5 (they were eligible to receive either Lemtrada again or any other MS disease-modifying drug)
  • Annualized relapse rates declined significantly over 2 years after patients started Lemtrada (CARE-MS I: 0.39 to 0.11; CARE-MS II: 0.52 to 0.15) and remained low through year 5 (CARE-MS I: 0.09; CARE-MS II: 0.18)
  • 75% of patients in CARE-MS I and 74% of patients in CARE-MS II did not experience disability worsening through year 5
  • 28% of patients in CARE-MS I and 23% of patients in CARE MS II experienced disability improvement through year 5
  • Yearly brain atrophy slowed to –0.07 in the CARE-MS I group and 0.02 in the CARE-MS II group in year 1 of the extension study after starting Lemtrada; it remained low through year 5 (–0.13 and –0.08)
  • 82% of patients in CARE-MS I and 81% of patients in CARE-MS II were free of MRI disease activity in year 2 of the extension study after starting Lemtrada; this remained high in year 5 (67% for both groups)

“The extension study data being presented at ECTRIMS illustrate that most patients who switched from IFNB-1a to Lemtrada experienced reduced disease activity,” said Aaron L. Boster, MD, Systems Medical Chief, Neuroimmunology for OhioHealth in Columbus, Ohio. “The improvements observed across relapse, disability, brain atrophy and MRI activity were maintained over 5 years, even though approximately two-thirds of patients received no additional treatment following the initial 2 courses of Lemtrada.”

Lemtrada is a CD52-directed cytolytic monoclonal antibody indicated for the treatment of patients with relapsing forms of multiple sclerosis. Because of its safety profile, the use of Lemtrada should generally be reserved for patients who have had an inadequate response to two or more drugs indicated for the treatment of MS.

Reference

Treatment Effects maintained over five years in patients with relapsing remitting multiple sclerosis who received sanofi genzyme's lemtrada® (alemtuzumab) in extension study after switching from interferon beta-1a [press release]. Cambridge, MA: Sanofi Genzyme; Accessed November 1, 2017.

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