Alemtuzumab improves neurological functional systems in treatment-naive relapsing-remitting multiple sclerosis patients

作者：Fox Edward J^*; Wynn Daniel; Coles Alasdair J; Palmer Jeffrey; Margolin David H

来源：Journal of the Neurological Sciences, 2016, 363: 188-194.

DOI：10.1016/j.jns.2016.02.025

• Alemtuzumab
• Disability
• Disease-modifying therapy
• Expanded Disability Status Scale
• Functional systems
• Multiple sclerosis

Background: Individual functional system scores (FSS) of the Expanded Disability Status Scale (EDSS) play a central role in determining the overall EDSS score in patients with early-stage multiple sclerosis (MS). Alemtuzumab treatment improves preexisting disability for many patients; however, it is unknown whether improvement is specific to certain functional systems.
Objective: We assessed the effect of alemtuzumab on individual FSS of the EDSS.
Methods: CAMMS223 was a 36-month, rater-blinded, phase 2 trial; treatment-naive patients with active relapsing-remitting MS, EDSS <= 3, and symptom onset within 3 years were randomized to annual courses of alemtuzumab or subcutaneous interferon beta-la (SC IFNB-1a) 44 mu g three times weekly.
Results: Alemtuzumab-treated patients had improved outcomes versus SC IFNB-1 a patients on most FSS at Month 36; the greatest effect occurred for sensory, pyramidal, and cerebellar FSS. Among patients who experienced 6 month sustained accumulation of disability, clinical worsening occurred most frequently in the brainstem and sensory systems. For patients with 6-month sustained reduction in preexisting disability, pyramidal and sensory systems contributed most frequently to clinical improvement.
Conclusions: Alemtuzumab demonstrated a broad treatment effect in improving preexisting disability. These findings may influence treatment decisions in patients with early, active relapsing-remitting MS displaying neurological deficits.

• 出版日期2016-4-15