Effectiveness of autologous haematopoietic stem cell transplantation versus natalizumab in progressive multiple sclerosis

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00064173%3A_____%2F24%3A43926895" target="_blank" >RIV/00064173:_____/24:43926895 - isvavai.cz</a>

Alternative codes found

RIV/00216208:11110/24:10478956 RIV/00216208:11120/24:43926895 RIV/00064165:_____/24:10478956

Result on the web

<a href="https://doi.org/10.1136/jnnp-2023-332790" target="_blank" >https://doi.org/10.1136/jnnp-2023-332790</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1136/jnnp-2023-332790" target="_blank" >10.1136/jnnp-2023-332790</a>

Result language

angličtina

Original language name

Effectiveness of autologous haematopoietic stem cell transplantation versus natalizumab in progressive multiple sclerosis

Original language description

BACKGROUND: Natalizumab was not shown to modify disability in progressive multiple sclerosis (MS). This matched observational study compared the effectiveness of autologous haematopoietic stem cell transplantation (AHSCT) with natalizumab in progressive MS. METHODS: Patients with primary/secondary progressive MS from seven AHSCT MS centres and the MSBase registry, treated with AHSCT or natalizumab, were matched on a propensity score derived from sex, age, Expanded Disability Status Scale (EDSS), number of relapses 12/24 months before baseline, time from MS onset, the most effective prior therapy and country. The pairwise-censored groups were compared on hazards of 6-month confirmed EDSS worsening and improvement, relapses and annualised relapse rates (ARRs), using Andersen-Gill proportional hazards models and conditional negative binomial model. RESULTS: 39 patients treated with AHSCT (37 with secondary progressive MS, mean age 37 years, EDSS 5.7, 28% with recent disability progression, ARR 0.54 during the preceding year) were matched with 65 patients treated with natalizumab. The study found no evidence for difference in hazards of confirmed EDSS worsening (HR 1.49, 95% CI 0.70 to 3.14) and improvement (HR 1.50, 95% CI 0.22 to 10.29) between AHSCT and natalizumab over up to 4 years. The relapse activity was also similar while treated with AHSCT and natalizumab (ARR: mean+-SD 0.08+-0.28 vs 0.08+-0.25; HR 1.05, 95% CI 0.39 to 2.82). In the AHSCT group, 3 patients experienced febrile neutropenia during mobilisation, 9 patients experienced serum sickness, 6 patients required intensive care unit admission and 36 patients experienced complications after discharge. No treatment-related deaths were reported. CONCLUSION: This study does not support the use of AHSCT to control disability in progressive MS with advanced disability and low relapse activity.

Czech name

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Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

—

OECD FORD branch

30210 - Clinical neurology

Project

—

Continuities

N - Vyzkumna aktivita podporovana z neverejnych zdroju

Publication year

2024

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Journal of Neurology, Neurosurgery &amp; Psychiatry

ISSN

0022-3050

e-ISSN

1468-330X

Volume of the periodical

95

Issue of the periodical within the volume

8

Country of publishing house

GB - UNITED KINGDOM

Number of pages

9

Pages from-to

775-783

UT code for WoS article

001194427900001

EID of the result in the Scopus database

2-s2.0-85190091661