%0 Journal Article
%A Van-Wijmeersch, Bart
%A Singer, Barry A
%A Boster, Aaron
%A Broadley, Simon
%A Fernandez, Oscar
%A Freedman, Mark S
%A Izquierdo, Guillermo
%A Lycke, Jan
%A Pozzilli, Carlo
%A Sharrack, Basil
%A Steingo, Brian
%A Wiendl, Heinz
%A Wray, Sibyl
%A Ziemssen, Tjalf
%A Chung, Luke
%A Margolin, David H
%A Thangavelu, Karthinathan
%A Vermersch, Patrick
%T Efficacy of alemtuzumab over 6 years in relapsing-remitting multiple sclerosis patients who relapsed between courses 1 and 2: Post hoc analysis of the CARE-MS studies.
%D 2019
%U http://hdl.handle.net/10668/14618
%X Alemtuzumab is administered as two annual courses for relapsing-remitting multiple sclerosis (MS). Patients may relapse before completing the two-course regimen. The objective was to evaluate 6-year outcomes in patients who relapsed between alemtuzumab Courses 1 and 2 (early relapsers). Post hoc analysis of patients from the Comparison of Alemtuzumab and Rebif® Efficacy in Multiple Sclerosis (CARE-MS) studies who enrolled in the extension. Early relapsers (CARE-MS I: 15%; CARE-MS II: 24%) had more relapses in 1-2 years pre-alemtuzumab and higher mean baseline Expanded Disability Status Scale score than patients without relapse. Their annualized relapse rate declined from Year 1 (CARE-MS I: 1.3; CARE-MS II: 1.2) to Year 2 following Course 2 (0.3; 0.5) and remained low thereafter. Over 6 years, 60% remained free of 6-month confirmed disability worsening; 24% (CARE-MS I) and 34% (CARE-MS II) achieved 6-month confirmed disability improvement. During Year 6, 69% (CARE-MS I) and 68% (CARE-MS II) were free of magnetic resonance imaging (MRI) disease activity. Median percent yearly brain volume loss (Year 1: -0.67% (CARE-MS I); -0.47% (CARE-MS II)) declined after Course 2 (Year 6: -0.24%; -0.13%). Early relapsers' outcomes improved after completing the second alemtuzumab course. These findings support administering the approved two-course regimen to maximize clinical benefit. 
%K Alemtuzumab
%K Disability
%K Disease-modifying therapy
%K Efficacy
%K Magnetic resonance imaging (MRI)
%K Relapsing–remitting multiple sclerosis (MS)
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