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Abstract Details

Confirmed Progression independent of Relapse Activity in Multiple Sclerosis Patients under long-term Natalizumab Treatment.
Multiple Sclerosis
P5 - Poster Session 5 (8:00 AM-9:00 AM)
9-012
To evaluate confirmed progression independent of relapse activity (cPIRA) as an indicator for secondary progressive multiple sclerosis (SPMS) during long-term natalizumab treatment in relapsing-remitting multiple sclerosis (RRMS) patients.
While early natalizumab treatment may delay SPMS conversion, real-world data on the long-term effect are rare.
We performed a retrospective chart review study of RRMS patients on long-term (≥24 months) natalizumab therapy at the University hospitals of Düsseldorf and Munich. cPIRA was defined as ≥12 week confirmed disability progression on a roving Expanded Disability Status Scale (EDSS) reference score by 1 point in patients with EDSS ≤3 or 0.5 in patients with EDSS ≥3.5 in the absence of a relapse.
We identified 194 patients on long-term natalizumab therapy. Of these patients, 44 developed cPIRA under natalizumab (22.7%), 140 patients remained relapsing-remitting (72.2%) and 10 patients developed cPIRA outside natalizumab therapy (5.1%). Kaplan Meier curves with cox proportional hazard models were used to analyze cPIRA development depending on both disease and natalizumab treatment duration. cPIRA occurred earlier in the disease course in patients with an earlier natalizumab therapy onset (≤8.6 versus >8.6 years, p<0.001), but the time on natalizumab until cPIRA did not differ between both groups (p=0.406). Time to cPIRA did not differ between patients with EDSS ≤3.5 and >3.5 at natalizumab onset neither in disease (p=0.075) nor in therapy duration (p=0.565). Furthermore, patients with >2 disease-modifying therapies (DMT) before natalizumab developed cPIRA significantly earlier in the disease course than patients with ≤2 DMTs prior to natalizumab (p=0.005), but the duration of natalizumab therapy before cPIRA did not differ (p=0.876).

More than 20% of patients on long-term natalizumab treatment developed cPIRA independent of the EDSS at natalizumab onset. The significant difference regarding the natalizumab onset analyses reflects that patients with a more severe disease course are more likely to receive natalizumab earlier.

Authors/Disclosures
Jonas Graf
PRESENTER 		No disclosure on file
No disclosure on file
No disclosure on file
No disclosure on file
No disclosure on file
Tania Kuempfel, MD (Institut for Klinische Neuroimmunologie) Dr. Kuempfel has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Kuempfel has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for UCB Pharma. Dr. Kuempfel has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Alexion. Dr. Kuempfel has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. Dr. Kuempfel has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Amgen/Horizon.
Hans-Peter Hartung, MD, FÂ鶹´«Ã½Ó³»­ (Heinrich Heine University Medical Faculty) Dr. Hartung has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BMS Celgene. Dr. Hartung has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Geneuro. Dr. Hartung has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Hartung has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Hartung has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Dr. Hartung has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bayer. Dr. Hartung has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TG Therapeutics. Dr. Hartung has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Hartung has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Frontiers Neurology.
Joachim Havla, MD (Univ Klinikum Grosshadern) Dr. Havla has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Dr. Havla has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Havla has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Havla has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Havla has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Havla has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Dr. Havla has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Celgene. Dr. Havla has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Merck. Dr. Havla has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. Dr. Havla has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen. Dr. Havla has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. The institution of Dr. Havla has received research support from Merck.
Orhan Aktas, MD (Neurologische Klinik) Dr. Aktas has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alexion. Dr. Aktas has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Amgen/Horizon. Dr. Aktas has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Aktas has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Mitsubish Tanake. Dr. Aktas has received personal compensation in the range of $500-$4,999 for serving as a Consultant for UCB. Dr. Aktas has received personal compensation in the range of $500-$4,999 for serving as a Consultant for AstraZeneca. Dr. Aktas has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sanofi. Dr. Aktas has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Alexion. Dr. Aktas has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. Dr. Aktas has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Amgen/Horizon. The institution of Dr. Aktas has received research support from German Research Foundation. The institution of Dr. Aktas has received research support from German Ministry of Science. The institution of Dr. Aktas has received research support from Neuromyelitis optica Study Group (NEMOS).
Philipp Albrecht, PhD (Neurologische Universitatsklinik Dusseldorf) Dr. Albrecht has received personal compensation for serving as an employee of Abbvie. Dr. Albrecht has received personal compensation for serving as an employee of Biogen. Dr. Albrecht has received personal compensation for serving as an employee of Bristol Myers Squibb. Dr. Albrecht has received personal compensation for serving as an employee of Ipsen. Dr. Albrecht has received personal compensation for serving as an employee of Merck. Dr. Albrecht has received personal compensation for serving as an employee of Merz. Dr. Albrecht has received personal compensation for serving as an employee of Novartis. Dr. Albrecht has received personal compensation for serving as an employee of Roche. Dr. Albrecht has received personal compensation for serving as an employee of Sanofi. Dr. Albrecht has received personal compensation for serving as an employee of Lilly.