Monoclonal Antibody for MS Yields Improvements in Patient Satisfaction, Outcomes

Switching to alemtuzumab yielded improvements in treatment satisfaction, fatigue, and side effects in patients being treated for relapsing-remitting multiple sclerosis (MS). Researchers published their findings in Multiple Sclerosis Journal – Experimental, Translational and Clinical.

Patients with relapsing-remitting MS have episodes of neurological dysfunction which initially resolve but become more severe as the disease progresses, investigators said.

The CARE-MS I and CARE-MS II studies showed the anti-CD52 monoclonal antibody alemtuzumab was associated with improvements in quality of life and clinical outcomes.  “However,” researchers said, “little is known about how alemtuzumab treatment influences quality of life for patients in real-world settings, particularly among those who switch to alemtuzumab from another disease-modifying therapy.”

The PRO-ACT study was a multicenter, observational study that followed adult patients in the United States and Canada for 24 months. By the end of the study, 170 of 199 participants were included in the analysis. Patients were predominantly women (75.4%) and White (85.9%) and were an average 43.7 years of age (range, 19-73).

Prior to switching to alemtuzumab, patients had been treated with a variety of disease-modifying therapies, including natalizumab, teriflunomide, dimethyl fumarate, fingolimod, siponimod, IFN-β-1a, IFN-β-1b, pegylated IFN-β-1a, and glatiramer acetate.

Alemtuzumab was administered intravenously at a dosage of 12 mg/day. The first course was administered over 5 consecutive days at baseline, and the second course of treatment came 12 months later, administered over 3 consecutive days.

Using the Treatment Satisfaction Questionnaire for Medication version 1.4, patients reported improvements in overall satisfaction (baseline, 50.3; year 2, +13.2; P < 0.0001), effectiveness (baseline, 49.3; year 2, +12.2; P < 0.0001), and side effects (baseline, 77.6; year 2, +4.5; P = 0.04).

Researchers also observed improvements in physical (baseline, 52.4; year 2, -6.0; P < 0.0001) and psychological (baseline, 53.4; year 2, -7.0; P = 0.0003) measures, as well as fatigue (baseline 12.8; year 2, -1.7; P < 0.0001).

Almost all participants (95%) experienced at least 1 adverse event during the study, most of which were mild (88.4%) or moderate (67.8%) in severity.

“Improvements were generally seen by 6 months and were maintained for up to 2 years after switching treatment,” researchers concluded. “Findings from PRO-ACT may inform discussions between patients and providers regarding patient expectations for treatment satisfaction, physical and psychological function, and quality of life improvements.”

Reference:
Wray S, Jacques F, Miller TA, et al. Satisfaction with alemtuzumab in relapsing multiple sclerosis patients: Results from the real-world PRO-ACT study. Mult Scler J Exp Transl Clin. 2022;8(4):20552173221135888. doi: 10.1177/20552173221135888