Alemtuzumab Use Among Narcoms Registry Participants

Background: Alemtuzumab is an anti-CD52 monoclonal antibody therapy that is approved in >65 countries for treatment of adults with relapsing forms of MS. There is a need for real-world data on patients treated with alemtuzumab.

Objectives: To describe demographic and clinical characteristics, as well as employment status of persons with MS who received alemtuzumab and participate in the North American Research Committee on Multiple Sclerosis (NARCOMS) Registry.

Methods: NARCOMS participants who started alemtuzumab and completed a follow-up survey 1 year later were identified from semi-annual update surveys between 2014 and 2017. At alemtuzumab initiation and 1 year later, demographic and clinical characteristics, including gender, race, age, employment status, MS clinical course and disability level using the Patient-Determined Disease Steps (PDDS) and Performance Scales (PS), were reported. Descriptive statistics were used to summarize relevant characteristics.

Results: Fifty NARCOMS participants reported initiating alemtuzumab and completed the 1-year survey. Characteristics of those participants included: 75.5% female; 78.0% Caucasian; mean (SD) age at initiation, 40.4 (10.1) years; mean age at symptom onset, 28.3 (8.0) years; mean age at diagnosis, 33.8 (9.0) years. Most had RRMS (48.0%) or SPMS (28.0%), and the remaining reported either ‘unsure/other’ (22.0%) or PPMS (2.0%). Mean disease duration was 18.6 (10.2) years, with 26.0% of participants reporting comorbidities. At treatment initiation, 68.0% had at least moderate disability based on PDDS (level 4: Early Cane), and 86.0% had mild or greater level of fatigue based on fatigue PS; 32.0% reported having a relapse treated with steroids prior to alemtuzumab. At 1 year, 56.0% had stable PDDS, 26.0% had improved PDDS; 60.0% and 22.0% had stable and improved fatigue PS, and 18.0% had worsened fatigue; 18.0% reported having a relapse treated with steroids during Year 1 after alemtuzumab initiation. Of those employed at initiation of therapy, 100% remained employed 1 year later.

Conclusions: After initiating alemtuzumab, the majority of participants reported improved/stable PDDS, improved/stable fatigue PS, and the percentage with relapse treated with steroids decreased. All employed NARCOMS participants with 1 year of follow-up survey data remained employed. These data show a favorable real-world patient experience after alemtuzumab treatment, supporting the positive outcomes shown in clinical trials.  

Study Support: Sanofi. NARCOMS is supported in part by the Consortium of Multiple Sclerosis Centers (CMSC) and the Foundation of the CMSC.