RRMS Patients Switching from SC IFNB-1a to Alemtuzumab in the CARE-MS I and II Extension Study Have a Reduced Rate of Brain Volume Loss (P6.183)
Bibliographic record
Abstract
Objective: To examine brain volume loss (BVL) before and after switching from SC IFNB-1a to alemtuzumab in the CARE-MS extension study (NCT00930553). Background: Active relapsing-remitting MS (RRMS) patients who were treatment-naive (CARE-MS I; NCT00530348) or who had an inadequate response (≥1 relapse) to prior therapy at baseline (CARE-MS II; NCT00548405) demonstrated 42[percnt] and 24[percnt] reduction, respectively, in brain atrophy rate with alemtuzumab versus SC IFNB-1a over 2 years. Durable slowing of BVL in patients who received core study alemtuzumab was observed through 5 years in the absence of additional treatment for most patients for 4 years. Design/Methods: Patients treated with SC IFNB-1a in the CARE-MS core studies for 2 years discontinued treatment and received 2 alemtuzumab courses at extension Months 0 and 12, then as-needed alemtuzumab retreatment for relapse or radiological activity. MRI scans were assessed at baseline and annually thereafter. BVL was derived by relative brain parenchymal fraction change. Results: The extension study enrolled 144 (83[percnt]) and 146 (83[percnt]) SC IFNB-1a-treated patients from CARE-MS I and II; 81[percnt] and 84[percnt] received no alemtuzumab retreatment since Month 12 after switching. Median yearly BVL in Year 2 on SC IFNB-1a in CARE-MS I (-0.50[percnt]) and CARE-MS II (-0.33[percnt]) was reduced in Years 1, 2, and 3 after switching to alemtuzumab (CARE-MS I: -0.07[percnt], -0.13[percnt], -0.09[percnt]; CARE-MS II: 0.02[percnt], -0.05[percnt], -0.14[percnt]). Despite this improvement, these patients still had 22[percnt] greater BVL at the end of Year 5 of the extension than those who received alemtuzumab in the core studies (CARE-MS I: -1.646[percnt] vs -1.352[percnt], and CARE-MS II: -1.044[percnt] vs -0.855[percnt]). Conclusions: Switching from SC IFNB-1a to alemtuzumab markedly slowed BVL over 3 years. Despite these beneficial effects, earlier use of alemtuzumab led to lower rates of BVL through 5 years. Study Supported By: Genzyme, a Sanofi company, and Bayer Healthcare Pharmaceuticals.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".