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Abstract Details

A Real-World Retrospective Analysis of Outcomes in Multiple Sclerosis Patients Who Transitioned to Alemtuzumab After Rituximab or Ocrelizumab
Multiple Sclerosis
P13 - Poster Session 13 (5:30 PM-6:30 PM)
9-005
To report demographics, treatment exposure, and selected outcomes in multiple sclerosis (MS) patients who transitioned from anti-CD20 therapies to alemtuzumab in real-world clinical settings.
Despite reduction in relapse rates/MRI activity, some relapsing-remitting MS patients on anti-CD20 antibody therapies (rituximab and ocrelizumab) have discontinued treatment due to lack of efficacy and adverse events. Data are limited on outcomes in patients who transition to other therapies.
This is a retrospective, electronic medical record, and claims-based study of commercially insured and Medicaid/Medicare enrollees with an alemtuzumab prescription/claim between November 2014 and September 2019, identified from the OM1® Real-World Data Cloud. Inclusion criteria: ≥2 International Classification of Diseases (ICD) codes for MS (340 in ICD-9; G35 in ICD-10), treatment with ≥1 alemtuzumab course, and prior treatment with rituximab or ocrelizumab. Pre-specified symptoms and comorbidities were assessed pre- and post-alemtuzumab initiation (index date).
Of 1383 alemtuzumab-treated MS patients, 39 (3%) received prior anti-CD20 therapies (28 rituximab, 10 ocrelizumab, 1 both). Mean (SD) age was 41.7 (11.1) years; 64.1% were female. Mean study duration was 64 months, and mean duration after alemtuzumab Course 1 was 18.5 months. Mean (SD) time from last anti-CD20 exposure to first alemtuzumab course was 12.7 (10.3) months for rituximab and 6.4 (1.6) months for ocrelizumab. In a cohort of patients with 12-month follow-up pre- and post-index date (n=25), the total numbers of reported symptoms (eg, muscle weakness) and comorbidities (eg, anxiety) were lower post-index versus pre-index (7 vs 39; and 17 vs 56, respectively).
In this small real-world cohort of MS patients who transitioned from anti-CD20 therapies to alemtuzumab, the total numbers of reported pre-specified symptoms and comorbidities were lower after initiating alemtuzumab. Further characterization of outcomes will inform the benefit versus risk of transitioning to alemtuzumab after discontinuing anti-CD20 therapies.
Authors/Disclosures
Marie Coste
PRESENTER 		No disclosure on file
No disclosure on file
Zia Choudhry No disclosure on file
Mark Ozog, PhD (Sanofi Genzyme) No disclosure on file
Lobat Hashemi No disclosure on file
Elizabeth Poole No disclosure on file
No disclosure on file
No disclosure on file
Bill Aschenbach No disclosure on file
Ben Guikema, PhD (Sanofi Genzyme) No disclosure on file