Van-Wijmeersch, BartSinger, Barry ABoster, AaronBroadley, SimonFernandez, OscarFreedman, Mark SIzquierdo, GuillermoLycke, JanPozzilli, CarloSharrack, BasilSteingo, BrianWiendl, HeinzWray, SibylZiemssen, TjalfChung, LukeMargolin, David HThangavelu, KarthinathanVermersch, Patrick2023-02-082023-02-082019-08-23Van Wijmeersch B, Singer BA, Boster A, Broadley S, Fernández Ó, Freedman MS, et al. 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. Mult Scler. 2020 Nov;26(13):1719-1728http://hdl.handle.net/10668/14618Alemtuzumab 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.enAttribution-NonCommercial 4.0 Internationalhttp://creativecommons.org/licenses/by-nc/4.0/AlemtuzumabDisabilityDisease-modifying therapyEfficacyMagnetic resonance imaging (MRI)Relapsing–remitting multiple sclerosis (MS)AlemtuzumabAntibodies, Monoclonal, HumanizedHumansInterferon beta-1aMultiple SclerosisMultiple Sclerosis, Relapsing-Remittingresearch article31675266open accessEsclerosis múltiple recurrente-remitenteEncéfaloEsclerosis múltipleImagen por resonancia magnéticaInterferón beta-1a10.1177/13524585198817591477-0970PMC7604550https://journals.sagepub.com/doi/pdf/10.1177/1352458519881759https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7604550/pdf