IRCCS Mondino Foundation

Author Of 1 Presentation

Observational Studies Poster Presentation

P0902 - Real world evidence of progression independent of relapsing activity among MS patients treated with Alemtuzumab. (ID 1165)

Speakers
Presentation Number
P0902
Presentation Topic
Observational Studies

Abstract

Background

Background:Disability accumulation can result from progression independent of relapsing activity (PIRA) even during the RR phase.

Objectives

Aims: We assessed the contribution of PIRA to the development of permanent disability, among RRMS treated with Alemtuzumab(ATZ).

Methods

Methods: retrospective data from 147 RRMS patients, who received ATZ at Imperial College Healthcare Trust, followed up for 3 mean years. PIRA was defined as 1.5point increase of EDSS if baseline EDSS was 0, 1point increase if baseline EDSS was <5.5, or 0.5point increase if baseline EDSS was >= 5.5,90days from the previous relapse. The logistic regression analysis was used to assess factors affecting the risk of PIRA.

Results

Results In the whole group female predominated (60%), 19% were treatment naïve and 81% were escalated to ATZ from previous DMTs; 15% (n = 23) received one course of ATZ only. At first ATZ infusion, the mean age was 42 years, the mean disease duration was 8 years and the mean EDSS score was 4. During the observation period, the EDSS remained stable in 58% (n=84) or improved in 11% (n = 17), while it worsened by 1.5 mean point (min 0.5 max 4.5) in 31% (n = 46). Among patients who experienced EDSS worsening, disability accumulation was related to PIRA in 76% (n = 35), while in only a minority (n = 11) it resulted from relapse-associated worsening. Compared to the whole group, patients with PIRA had at first ATZ infusion same mean EDSS score (4, p =0.8), but they had longer disease duration (11 versus 7 mean years, p=0.007), were significantly older both at disease onset (36 vs 32 mean years, p=0.046) and at commencement of the therapy (47 vs 40 mean years, p=0.001). In addition, in the PIRA group vast majority (94%) of patients were escalated to ATZ after lack of response to previous DMTs. The logistic regression analysis confirmed that older age at first ATZ course (OR 6.7, p=0.037) and being escalated to ATZ from previous DMTs (OR 1.1, p= 0.002) are factors significantly associated with higher risk of PIRA.

Conclusions

Conclusions We confirmed in the real-world setting that in a large proportion of patients the disability accumulation can occur despite effective therapeutic relapse suppression. Older patients receiving ATZ as escalation therapy are more likely to experience PIRA.

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Presenter Of 1 Presentation

Observational Studies Poster Presentation

P0902 - Real world evidence of progression independent of relapsing activity among MS patients treated with Alemtuzumab. (ID 1165)

Speakers
Presentation Number
P0902
Presentation Topic
Observational Studies

Abstract

Background

Background:Disability accumulation can result from progression independent of relapsing activity (PIRA) even during the RR phase.

Objectives

Aims: We assessed the contribution of PIRA to the development of permanent disability, among RRMS treated with Alemtuzumab(ATZ).

Methods

Methods: retrospective data from 147 RRMS patients, who received ATZ at Imperial College Healthcare Trust, followed up for 3 mean years. PIRA was defined as 1.5point increase of EDSS if baseline EDSS was 0, 1point increase if baseline EDSS was <5.5, or 0.5point increase if baseline EDSS was >= 5.5,90days from the previous relapse. The logistic regression analysis was used to assess factors affecting the risk of PIRA.

Results

Results In the whole group female predominated (60%), 19% were treatment naïve and 81% were escalated to ATZ from previous DMTs; 15% (n = 23) received one course of ATZ only. At first ATZ infusion, the mean age was 42 years, the mean disease duration was 8 years and the mean EDSS score was 4. During the observation period, the EDSS remained stable in 58% (n=84) or improved in 11% (n = 17), while it worsened by 1.5 mean point (min 0.5 max 4.5) in 31% (n = 46). Among patients who experienced EDSS worsening, disability accumulation was related to PIRA in 76% (n = 35), while in only a minority (n = 11) it resulted from relapse-associated worsening. Compared to the whole group, patients with PIRA had at first ATZ infusion same mean EDSS score (4, p =0.8), but they had longer disease duration (11 versus 7 mean years, p=0.007), were significantly older both at disease onset (36 vs 32 mean years, p=0.046) and at commencement of the therapy (47 vs 40 mean years, p=0.001). In addition, in the PIRA group vast majority (94%) of patients were escalated to ATZ after lack of response to previous DMTs. The logistic regression analysis confirmed that older age at first ATZ course (OR 6.7, p=0.037) and being escalated to ATZ from previous DMTs (OR 1.1, p= 0.002) are factors significantly associated with higher risk of PIRA.

Conclusions

Conclusions We confirmed in the real-world setting that in a large proportion of patients the disability accumulation can occur despite effective therapeutic relapse suppression. Older patients receiving ATZ as escalation therapy are more likely to experience PIRA.

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