Abstract Details

Title The Marburg Multiple Sclerosis - Cohort — Loss of MEDA under two standard treatment sequences

Topic Multiple Sclerosis

Presentation(s) P4 - Poster Session 4 (5:30 PM-6:30 PM)

Poster/Presentation
Number 15-031

Objective

To evaluate clinical responses of 2 standard treatment sequences in relapsing Multiple Sclerosis.

Background In the treatment of relapsing remitting multiple sclerosis the paradigm „No evidence of disease activity“ is postulated being one target in the treatment of R-MS. However, the majority of patients need drug sequences due to disease breakthrough under a first or second line treatment. We analysed time to loss of „minimal evidence of disease activity (MEDA)“ under two standard treatment sequences.

Design/Methods We included all patients with first-line therapy either with interferon-beta/Glatirameracetat or dimethyl fumarate (DMF) and focused on those patients with a need for escalation to a second-line therapy with either fingolimod (FTY) or monoclonal antibodies (mabs; natalizumab, ocrelizumab/rituximab, alemtuzumab).”Loss of MEDA” was defined as EDSS progression of >/=1.5 points at any time during an eight year observation period. Kaplan-Meier analyses were performed, defining p<0.05 being statistically significant.

Results

Between 2011 and 2018 n=1411 patients with MS according to McDonald criteria were included in the Marburg MS-Cohort. The gender ratio was 1:3 (m:f) and the mean age at diagnosis was 34 years. 79% of cases were diagnosed as RR-MS; 15.4% as SP-MS and 5.6% as PP-MS. N=134 patient received first-line therapy with DMF, whereof n=21 patients were escalated to (FTY) and n=7 escalated to mabs. N=665 patients received interferon or glatiramer acetate as first-line therapy. N=85 switched to fingolimod and n=90 switched to mabs. The time to “loss of MEDA” was longer in the DMF to FTY group than in the IFN/GLAT to FTY group, but there was no significant difference between the DMF to mabs and IFN/GLAT to mabs group.

Conclusions

DMF to FTY seems to be an efficacious treatment sequence because we found the lowest number of “Loss of MEDA” patients during an eight year observation period. Further analyses from registries are needed to confirm this finding.

Authors/Disclosures
Jan P. Jurs (Universitätsklinikum Marburg) PRESENTER	Mr. Jurs has nothing to disclose.
	No disclosure on file
	No disclosure on file
	No disclosure on file
Björn Tackenberg, MD, FAAN (F. Hoffmann-La Roche AG)	Dr. Tackenberg has received personal compensation for serving as an employee of F. Hoffmann-La Roche AG. Dr. Tackenberg has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Roche. Dr. Tackenberg has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Merck Serono. Dr. Tackenberg has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biogen. Dr. Tackenberg has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. Dr. Tackenberg has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for GILEAD. Dr. Tackenberg has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Alexion. Dr. Tackenberg has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Celgene. Dr. Tackenberg has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Tackenberg has received personal compensation in the range of $50,000-$99,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Dr. Tackenberg has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Tackenberg has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Celgene. Dr. Tackenberg has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Tackenberg has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Roche. Dr. Tackenberg has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Merck Serono. Dr. Tackenberg has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Biogen. Dr. Tackenberg has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Novartis. Dr. Tackenberg has received stock or an ownership interest from F. Hoffmann-La Roche AG. The institution of Dr. Tackenberg has received research support from Biogen. The institution of Dr. Tackenberg has received research support from Novartis. The institution of Dr. Tackenberg has received research support from Roche.

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