Abstract: A Single-Center Review Of Therapies Used Prior To Alemtuzumab In Patients With Multiple Sclerosis (2018 Annual Meeting of the Consortium of Multiple Sclerosis Centers)

DX09
A Single-Center Review Of Therapies Used Prior To Alemtuzumab In Patients With Multiple Sclerosis

Thursday, May 31, 2018

Exhibit Hall A (Nashville Music City Center)

Suma Shah, MD , Neurology, Duke University, Durham, NC

Anastasie Dunn-Pirio, MD, MS , Neurology, Duke University, Durham, NC

Jenelle M. Hall, PharmD , Duke University Health System, Durham, NC

Bryan Walker, PA-C , Neurology, Duke University, Durham, NC

Nick Hudak, PA-C , Neurology, Duke University, Durham, NC

Fletcher Hartsell, MD , Neurology, Duke University, Durham, NC

Mark Skeen, MD , Neurology, Duke University, Durham, NC

Christopher Eckstein, MD , Neurology, Duke University, Durham, NC

PDF

Background: Multiple sclerosis (MS) is an autoimmune neurologic disease that is one of the leading causes of disability in young Americans. There are currently no modalities that allow providers to assess which disease modifying therapy (DMT) might be best suited for any individual patient. Nor are there any widely accepted algorithms regarding DMT sequencing. Often, DMT are selected based on perceived disease course, patients’ risk aversion, and provider discretion. Alemtuzumab is a highly efficacious MS therapy that may result in secondary autoimmunity in a significant number of people. Available data on patients who switch to alemtuzumab is limited and in the form of observational studies.

Objectives: The primary goal of the study will be to evaluate the prior DMT use and disease characteristics in patients who receive alemtuzumab for management of MS.

Methods: All adult patients >18 years of age who received alemtuzumab at Duke University Medical Center from January 1, 2015 to November 1, 2017 were retrospectively identified from the Lemtrada REMS facility database. Basic patient information including age, sex, year of diagnosis, date of first infusion, and details of prior DMTs were collected from the hospital electronic medical record.

Results: Data was available on 32 patients (ages ranging from 29-63, median age 42). The gender distribution of our patients was 74% female and 26% male. Patients received an average of 3.6 DMTs prior to alemtuzumab treatment. Avonex, Copaxone, Gilenya, Tysabri, and Tecfidera were the most frequently prescribed DMTs prior to treatment with alemtuzmab. Average time from diagnosis until treatment with alemtuzumab was 12 years, with a median time of 10 years.

Conclusions: Patients within our center have typically received 3-4 previous DMTs prior to alemtuzumab treatment. Within our cohort, treatment decisions were most often based on therapeutic failure of previous therapies as opposed to DMT intolerance.

DX09 A Single-Center Review Of Therapies Used Prior To Alemtuzumab In Patients With Multiple Sclerosis

DX09
A Single-Center Review Of Therapies Used Prior To Alemtuzumab In Patients With Multiple Sclerosis