aHSCT is superior to alemtuzumab in maintaining NEDA and improving cognition in multiple sclerosis
Abstract Objective Autologous hematopoietic stem cell transplantation (aHSCT) is increasingly recognized as a potential therapy for patients with highly active multiple sclerosis (MS). This study aims to assess outcome differences in disease activity in MS patients treated either with aHSCT or alemt...
Main Authors: | , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Wiley
2021-06-01
|
Series: | Annals of Clinical and Translational Neurology |
Online Access: | https://doi.org/10.1002/acn3.51366 |
id |
doaj-96a40fa750014c9e84c1963b7b94bb74 |
---|---|
record_format |
Article |
spelling |
doaj-96a40fa750014c9e84c1963b7b94bb742021-05-30T16:53:11ZengWileyAnnals of Clinical and Translational Neurology2328-95032021-06-01861269127810.1002/acn3.51366aHSCT is superior to alemtuzumab in maintaining NEDA and improving cognition in multiple sclerosisVivien Häußler0Friederike Ufer1Jana Pöttgen2Christine Wolschke3Manuel A. Friese4Nicolaus Kröger5Christoph Heesen6Jan‐Patrick Stellmann7Institute of Neuroimmunology and Multiple Sclerosis University Medical Centre Hamburg‐Eppendorf Falkenried 94 Hamburg20251GermanyInstitute of Neuroimmunology and Multiple Sclerosis University Medical Centre Hamburg‐Eppendorf Falkenried 94 Hamburg20251GermanyInstitute of Neuroimmunology and Multiple Sclerosis University Medical Centre Hamburg‐Eppendorf Falkenried 94 Hamburg20251GermanyDepartment of Stem Cell Transplantation University Medical Center Hamburg‐Eppendorf Martinistraße 52 Hamburg20246GermanyInstitute of Neuroimmunology and Multiple Sclerosis University Medical Centre Hamburg‐Eppendorf Falkenried 94 Hamburg20251GermanyDepartment of Stem Cell Transplantation University Medical Center Hamburg‐Eppendorf Martinistraße 52 Hamburg20246GermanyInstitute of Neuroimmunology and Multiple Sclerosis University Medical Centre Hamburg‐Eppendorf Falkenried 94 Hamburg20251GermanyInstitute of Neuroimmunology and Multiple Sclerosis University Medical Centre Hamburg‐Eppendorf Falkenried 94 Hamburg20251GermanyAbstract Objective Autologous hematopoietic stem cell transplantation (aHSCT) is increasingly recognized as a potential therapy for patients with highly active multiple sclerosis (MS). This study aims to assess outcome differences in disease activity in MS patients treated either with aHSCT or alemtuzumab. Methods We conducted a monocentric registry‐based cohort study by recording the clinical course (EDSS and relapses), MRI parameters (new T2 lesions), and neuropsychological assessment in all 19 MS patients receiving aHSCT, and all 21 patients receiving alemtuzumab between 2007 and 2018. We used survival analyses of no evidence of disease activity (NEDA) as the primary objective which was defined by no EDSS progression, no relapse, and no new T2 lesion on MRI. Secondary objectives were EDSS improvement and neurocognitive performance. Results Both treatment groups were similar in respect of age, gender, disability, and neurocognitive performance except for significantly longer disease duration in the alemtuzumab group. Mean follow‐up was 58.8 [range 29–140] months in the aHSCT group compared to 27.6 [range 11–52] months in the alemtuzumab‐treated group. We observed significantly more patients maintaining NEDA in the aHSCT group (p = 0.048) compared to the alemtuzumab‐treated patients. Furthermore, 37% of the aHSCT patients showed an improvement of EDSS compared to none in the alemtuzumab‐treated group (p = 0.033). It is of note that cognitive function was significantly improved in the aHSCT‐treated patients. Interpretation aHSCT suppresses inflammatory activity more effectively than alemtuzumab and might enable improvement of overall disability and cognition in MS.https://doi.org/10.1002/acn3.51366 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Vivien Häußler Friederike Ufer Jana Pöttgen Christine Wolschke Manuel A. Friese Nicolaus Kröger Christoph Heesen Jan‐Patrick Stellmann |
spellingShingle |
Vivien Häußler Friederike Ufer Jana Pöttgen Christine Wolschke Manuel A. Friese Nicolaus Kröger Christoph Heesen Jan‐Patrick Stellmann aHSCT is superior to alemtuzumab in maintaining NEDA and improving cognition in multiple sclerosis Annals of Clinical and Translational Neurology |
author_facet |
Vivien Häußler Friederike Ufer Jana Pöttgen Christine Wolschke Manuel A. Friese Nicolaus Kröger Christoph Heesen Jan‐Patrick Stellmann |
author_sort |
Vivien Häußler |
title |
aHSCT is superior to alemtuzumab in maintaining NEDA and improving cognition in multiple sclerosis |
title_short |
aHSCT is superior to alemtuzumab in maintaining NEDA and improving cognition in multiple sclerosis |
title_full |
aHSCT is superior to alemtuzumab in maintaining NEDA and improving cognition in multiple sclerosis |
title_fullStr |
aHSCT is superior to alemtuzumab in maintaining NEDA and improving cognition in multiple sclerosis |
title_full_unstemmed |
aHSCT is superior to alemtuzumab in maintaining NEDA and improving cognition in multiple sclerosis |
title_sort |
ahsct is superior to alemtuzumab in maintaining neda and improving cognition in multiple sclerosis |
publisher |
Wiley |
series |
Annals of Clinical and Translational Neurology |
issn |
2328-9503 |
publishDate |
2021-06-01 |
description |
Abstract Objective Autologous hematopoietic stem cell transplantation (aHSCT) is increasingly recognized as a potential therapy for patients with highly active multiple sclerosis (MS). This study aims to assess outcome differences in disease activity in MS patients treated either with aHSCT or alemtuzumab. Methods We conducted a monocentric registry‐based cohort study by recording the clinical course (EDSS and relapses), MRI parameters (new T2 lesions), and neuropsychological assessment in all 19 MS patients receiving aHSCT, and all 21 patients receiving alemtuzumab between 2007 and 2018. We used survival analyses of no evidence of disease activity (NEDA) as the primary objective which was defined by no EDSS progression, no relapse, and no new T2 lesion on MRI. Secondary objectives were EDSS improvement and neurocognitive performance. Results Both treatment groups were similar in respect of age, gender, disability, and neurocognitive performance except for significantly longer disease duration in the alemtuzumab group. Mean follow‐up was 58.8 [range 29–140] months in the aHSCT group compared to 27.6 [range 11–52] months in the alemtuzumab‐treated group. We observed significantly more patients maintaining NEDA in the aHSCT group (p = 0.048) compared to the alemtuzumab‐treated patients. Furthermore, 37% of the aHSCT patients showed an improvement of EDSS compared to none in the alemtuzumab‐treated group (p = 0.033). It is of note that cognitive function was significantly improved in the aHSCT‐treated patients. Interpretation aHSCT suppresses inflammatory activity more effectively than alemtuzumab and might enable improvement of overall disability and cognition in MS. |
url |
https://doi.org/10.1002/acn3.51366 |
work_keys_str_mv |
AT vivienhaußler ahsctissuperiortoalemtuzumabinmaintainingnedaandimprovingcognitioninmultiplesclerosis AT friederikeufer ahsctissuperiortoalemtuzumabinmaintainingnedaandimprovingcognitioninmultiplesclerosis AT janapottgen ahsctissuperiortoalemtuzumabinmaintainingnedaandimprovingcognitioninmultiplesclerosis AT christinewolschke ahsctissuperiortoalemtuzumabinmaintainingnedaandimprovingcognitioninmultiplesclerosis AT manuelafriese ahsctissuperiortoalemtuzumabinmaintainingnedaandimprovingcognitioninmultiplesclerosis AT nicolauskroger ahsctissuperiortoalemtuzumabinmaintainingnedaandimprovingcognitioninmultiplesclerosis AT christophheesen ahsctissuperiortoalemtuzumabinmaintainingnedaandimprovingcognitioninmultiplesclerosis AT janpatrickstellmann ahsctissuperiortoalemtuzumabinmaintainingnedaandimprovingcognitioninmultiplesclerosis |
_version_ |
1721419841743618048 |