Abstract Details

Title A Retrospective Chart Review of Lymphocyte Reconstitution Among MS Patients After Discontinuation of Dimethyl Fumarate

Topic Multiple Sclerosis

Presentation(s) MS and CNS Inflammatory Disease Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 226

Objective To characterize lymphocyte count profiles after discontinuation of dimethyl fumarate (DMF) in patients with multiple sclerosis (MS) who have lymphopenia in a real-world cohort.

Background DMF treatment in relapsing MS patients is associated with ~30% decrease in absolute lymphocyte count (ALC) followed by stabilization after 1 year. Clinical trial and real-world data suggest meaningful reconstitution occurs within 2-4 months after discontinuation of DMF, and additional real-world data can further inform on treatment strategy.

Design/Methods Retrospective patient-level data abstracted from US medical records at a single-center were collected from patients treated with DMF, according to the US prescribing information. A longitudinal analysis of on-treatment and post-DMF lymphocyte profiles was performed on patients who had a recorded DMF discontinuation date and a recorded ALC less than the lower limit of normal (LLN; 0.91 x 10⁹/L) before or at time of discontinuation. Due to variable post-DMF ALC assessment timing, the 3-month follow-up period permitted for a +/- 1-month window.

Results Thirteen patients had an ALC < LLN at the time of DMF discontinuation and are included in this analysis. At the time of DMF initiation, mean (SD) age was 53.7 (13.1) years. The mean (SD) ALC was 0.6 (0.2) x10⁹/L while on-treatment. Most patients (8/13) discontinued due to lymphopenia. The mean (SD) ALC at the time of discontinuation was 0.7 (0.2) x10⁹/L, and was 1.5 (1) x10⁹/L for the post-DMF period. Most patients (12/13) reached 0.9 x 10⁹/L after discontinuation; the mean (SD) ALC at 3 months was 0.9 (0.4) x 10⁹/L; the mean (SD) time to the next DMT initiation was 58.4 (48.1) days.

Conclusions

In this real-world cohort of MS patients treated with DMF, meaningful lymphocyte reconstitution occurred within 3 months of DMF discontinuation.

Study Supported by: Biogen

Authors/Disclosures
Stephen M. Newman, MD PRESENTER	Dr. Newman has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Biogen. Dr. Newman has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis . Dr. Newman has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi-Genzyme . Dr. Newman has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for Biogen.
Nicole M. Scott, PharmD (Biogen)	Dr. Scott has received personal compensation for serving as an employee of Biogen.
	No disclosure on file
Justin Bohn	Justin Bohn has received personal compensation for serving as an employee of Biogen. Justin Bohn has received stock or an ownership interest from Biogen.
	No disclosure on file
	No disclosure on file
	No disclosure on file

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