Switching to Alemtuzumab From Subcutaneous Interferon Beta-1a After CARE-MS II Further Improved MRI Outcomes in Patients With Relapsing-Remitting Multiple Sclerosis (P7.248)
Bibliographic record
Abstract
OBJECTIVE: Examine magnetic resonance imaging (MRI) outcomes in patients who switched to alemtuzumab after receiving subcutaneous interferon beta-1a (SC IFNB-1a) in CARE-MS II. BACKGROUND: In the 2-year CARE-MS II study (NCT00548405) of relapsing-remitting multiple sclerosis patients who relapsed on prior therapy, alemtuzumab demonstrated improvements in many MRI outcomes, including reductions in MRI lesion activity and brain volume loss, compared with SC IFNB-1a. A CARE-MS extension study (NCT00930553) is ongoing. DESIGN/METHODS: In CARE-MS II, SC IFNB-1a-treated patients received 44 μg, 3 times/week for 2 years. In the extension, former SC IFNB-1a-treated patients received annual alemtuzumab courses in Years 3 and 4 (12 mg intravenous). MRI outcomes assessed at baseline and yearly included gadolinium (Gd)-enhancing, new/enlarging T2 hyperintense and new T1 hypointense lesion activity, and MRI activity-free (absence of Gd-enhancing and new/enlarging T2 lesions). RESULTS: The extension enrolled 146 (83.4[percnt]) former SC IFNB-1a-treated patients; 89.7[percnt] received 2 alemtuzumab courses; 8.2[percnt] received 1 course, and 4.8[percnt] discontinued the study. After switching to alemtuzumab, proportions of patients lesion activity-free increased in Year 4 on alemtuzumab compared with Year 2 on SC IFNB-1a (Gd-enhancing [91.1[percnt] vs 77.6[percnt]; P<0.001], new/enlarging T2 [80.9[percnt] vs 47.7[percnt]; P<0.001]; new T1 [93.1[percnt] vs 73.8[percnt]; P<0.001]). Proportion of patients MRI activity-free was higher in Year 4 on alemtuzumab compared with Year 2 on SC IFNB-1a (80.9[percnt] vs 46.8[percnt]; P<0.001). Yearly rate of new lesion formation declined from Year 2 on SC IFNB-1a to Year 4 on alemtuzumab (new Gd-enhancing: 0.83 to 0.53; new/enlarging T2: 3.88 to 1.41; new T1: 0.93 to 0.22). CONCLUSIONS: Switching from SC IFNB-1a to alemtuzumab improved the proportion of patients MRI activity-free. These findings further confirm the superior efficacy of alemtuzumab in patients who received more than 2 years of prior disease-modifying therapy. 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 | 0.000 |
| 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) | 0.001 | 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".