The use of continuous ofatumumab in patients within three years of a relapsing multiple sclerosis diagnosis led to substantial reductions in associated lesions on brain MRI scans, according to research recently presented at the American Academy of Neurology (AAN) conference.
Magnetic resonance imaging (MRI) scans for recently diagnosed treatment-naive patients with relapsing multiple sclerosis (RMS) revealed 96.4 percent reductions in Gd+ T1 lesions and 82.7 percent reductions in neT2 lesions after continuous treatment with ofatumumab for up to six years, according to the ALITHIOS open-label extension study presented at the American Academy of Neurology (AAN) conference in Denver.
The use of continuous first-line ofatumumab (Kesimpta®, Novartis) within three years of an RMS diagnosis also led to a 44 percent reduction in relapses in comparison to patients who switched from teriflunomide to ofatumumab. Other findings for these patients included a 21.6 percent reduction of six-month confirmed disability worsening (CDW) in comparison to patients who switched to ofatumumab from teriflunomide, according to the study authors.
"Our analysis of treatment-naïve people who were recently diagnosed with relapsing multiple sclerosis found that first-line use of Kesimpta for up to six years provided long-term benefits, including fewer relapses, profoundly suppressed MRI lesion activity, and fewer disability worsening events," said principal investigator Gabriel Pardo, M.D., the founding director of the Multiple Sclerosis Center of Excellence at Oklahoma Medical Research Foundation.
For recently diagnosed treatment naïve (RDTN) patients who were initially treated with teriflunomide for RMS, the researchers found that switching to ofatumumab resulted in a 98.5 percent reduction of Gd+ T1 lesions and a 93 percent reduction in neT2 lesions on MRI as well as a 71.3 percent reduction in the annualized relapse rate (ARR).
In a second related analysis from the AAN conference assessing six-year outcomes with ofatumumab in the entire ALITHIOS trial cohort, the study authors noted a 56.7 reduction of Gd+ T1 lesions and an 89.3 percent reduction of neT2 lesions on MRI brain scans. For patients who switched from teriflunomide to ofatumumab, researchers pointed to a 97.7 percent reduction of Gd+ T1 lesions and a 91.8 reduction of neT2 lesions on MRI.
In both studies, researchers noted that six-month CDW rates were higher for patients switching from teriflunomide to ofatumumab in comparison to those who received continuous ofatumumab.
"While measurable improvements were also seen in patients switching to Kesimpta later on, the delay in irreversible disability worsening was not fully realized in the switch group compared to those starting on Kesimpta first, reinforcing the value of introducing the treatment to patients earlier,” added Dr. Pardo.
References
1. Pardo G, Hauser SL, Bar-Or A, et al. Longer-term (up to 6 years) efficacy of ofatumumab in people with recently diagnosed and treatment-naïve relapsing multiple sclerosis. Presented at the American Academy of Neurology (AAN) 2024 Annual Meeting, April 13-18, 2024, Denver. Available at: https://www.aan.com/events/annual-meeting
2. Wiendl H, Hauser SL, Nicholas J, et al. Longer-term safety and efficacy of ofatumumab in people with relapsing multiple sclerosis for up to 6 years. Poster presentation at the American Academy of Neurology (AAN) 2024 Annual Meeting, April 13-18, 2024, Denver. Available at: https://www.aan.com/events/annual-meeting
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