Study Compares Alemtuzumab to Other Multiple Sclerosis Treatments

Over the course of a patients lifetime they will likely shift between various multiple sclerosis treatments. A recent study compared some of the more popular options on a variety of levels.

Tomas Kalincik, MD, PhD, from the Royal Hospital Melbourne in Australia discussed the results of the study during the annual ECTRIMS meeting in London:

What was the topic of your presentation?

The research that I’m presenting at this conference is a large collaborative effort between MSBase, a large international MS cohort and 7 collaborating centers in UK and in Germany.

We are looking at comparative efficacy of four highly effective therapies for multiple sclerosis. alemtuzumab versus natalizumab, fingolimod, or interferon beta 1a subcutaneously, also known as rebif.

What were you hoping to learn?

The main outcome of our research is annualized relapse rates, the probability of patients experiencing relapses, the probability of confirmed progression and probability of confirmed regression of up to five years.

How was the study conducted?

The study is designed using a large observational data cohort. The MSBase forms the basis for the study. It is a cohort that consists of 41,000 patients, amounting to 210,000 patient years from 119 centers in 35 countries. It is enriched by data from 7 centers that specifically treat patients with alemtuzumab as I said in the UK and in Germany.

What were your findings?

We have used propensity score based matching protocol which is well known to our team and we have used in our previous comparisons of therapy.

The main findings are that we have largely replicated the results of an original pivotal trial of alemtuzumab versus rebif. Showing superiority of alemtuzumab on relapse outcomes and also in patients with previously highly active MS, superiority of alemtuzumab on disability outcomes relative to rebif.

The exploratory state stage of the study is a comparison of alemtuzumab to fingolimod and comparison of alemtuzumab to natalizumab. We have observed that alemtuzumab is more efficient in suppressing relapse activity than fingolimod.

We have then observed that its efficacy in suppressing relapse activity is comparable to that of natalizumab.

Also, disability outcomes on alemtuzumab and natalizumab are largely comparable in terms of confirmed progression of disability. But, interestingly natalizumab is more likely to be associated with a confirmed regression of disability within the first year of treatment relevant to alemtuzumab.