Abstract Details

Title Retrospective Evaluation of De-Escalation from Anti-CD20 Therapies to Fumarates as a Treatment Approach

Topic Multiple Sclerosis

Presentation(s) P3 - Poster Session 3 (5:30 PM-6:30 PM)

Poster/Presentation
Number 12-003

Background Rituximab and ocrelizumab, used in the treatment of MS, are monoclonal antibodies directed against the CD20 antigen. For various reasons, patients may need to transition from anti-CD20 therapy, though data documenting transitions is limited.

Objective To describe patients who switched from anti-CD20 therapy to fumarates in the treatment of multiple sclerosis(MS)

Design/Methods

We describe characteristics of patients who switched from anti-CD20s to dimethyl fumarate (DMF) at the Rocky Mountain MS Center at University of Colorado within 12 months of last anti-CD20 infusion. Patients were followed from anti-CD20 initiation up to 24 months after DMF initiation or until DMF discontinuation, if sooner.

Results Ten patients were included in this study. Mean age at anti-CD20 initiation was 37.1 years; mean disease duration was 10.2 years; and 70% were female. All patients had relapsing-remitting MS and initiated rituximab prior to switching. Patients received a mean of 3 rituximab doses, with a mean cumulative dose of 2950mg. Two patients experienced clinical relapses, 1 of which had new lesions while on rituximab. No patients had enhancing lesions while on rituximab. Reasons for switching from anti-CD20 to DMF included insurance issues(n=5), recurrent infections(n=2), neutropenic fever(n=1), convenience of an oral pill(n=1), and anxiety caused by infusions(n=1). One patient had 2 clinical relapses occurring in the first 5 months of DMF and 1 patient had 1 new lesion detected in the first 6 months on DMF. Neither of these patients had disease activity on rituximab. No patients had enhancing lesions while on DMF. Three patients discontinued DMF after 1, 4, and 5 months due to tolerability issues or relapse.

Conclusions

We present real-life data on the patient experience of switching from anti-CD20s to DMF. Patients had a variety of motivations for switching to DMF from anti-CD20s. Additional patients will be presented.

Biogen provided funding for this study.

Authors/Disclosures
Enrique Alvarez, MD, PhD (University of Colorado) PRESENTER	Dr. Alvarez has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TG Therapeutics. Dr. Alvarez has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Alvarez has received personal compensation in the range of $50,000-$99,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EMD Serono. Dr. Alvarez has received personal compensation in the range of $50,000-$99,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Alvarez has received personal compensation in the range of $50,000-$99,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Alvarez 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. Alvarez has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Dr. Alvarez has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Celgene/BMS. The institution of an immediate family member of Dr. Alvarez has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for UCB. The institution of Dr. Alvarez has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon.
Brandi L. Vollmer, MPH (Columbia University, Anschutz Medical Campus)	Ms. Vollmer has nothing to disclose.
Evan Riddle, PhD	Dr. Riddle has received personal compensation for serving as an employee of Biogen. Dr. Riddle has received stock or an ownership interest from Biogen.
Jason Mendoza (Biogen)	No disclosure on file