Learning More About Cycling Between Multiple Sclerosis Treatments

As patients cycle between treatments for multiple sclerosis, there can be questions about how they will react to the various medications after switching. Comparing alemtuzumab and natalizumab provided doctors with at least some insight into this question.

Speaking at the annual ECTRIMS conference in London, UK, Tomas Kalincik, MD, PhD, from the Royal Melbourne Hospital, said having results comparing the two drugs could go a long way in helping providers determine which order to offer the medications to patients:

Was safety considered in this research?

We have not looked at the adverse events and safety of the medication simply because the density of the information in MSBase and the seven centers that we are collaborating with is not comparable, but in the future, we are looking at the opportunity to run safety registries through MSBase where our MSBase safety data will become more complete and allow this type of analysis.

What was the goal of comparing treatments?

This particular scenario is important because many patients will be discontinuing natalizumab, for example, and one of the options that their physicians would offer them is switch to another medication, it’s the most likely option.

The medication can be fingolimod, but the medication now can also be alemtuzumab, so it is interesting for us to see whether it is likely that alemtuzumab will have the same chance of keeping the disease under control that the natalizumab would have had.

We have included the rebif mainly for the reason that we wanted to replicate the results of the original trials, thereby demonstrating the validity of our analytic approach.

Were there surprises in your findings?

The surprising finding, I think is that natalizumab showed that earlier more likely improvement in terms of disability compared to alemtuzumab. Another finding that we were completely uncertain about was how alemtuzumab compares to natalizumab. So, even knowing that alemtuzumab and natalizumab are largely comparable is a very interesting and important observation for the clinician.