Choosing Between Stem Cell Transplantation or Fingolimod to Treat Highly Active MS: Tomas Kalincik, MD, PhD

Tomas Kalincik, MD, PhD, presented a late-breaking poster on the comparative effectiveness of autologous hematopoietic stem cell transplantation (AHSCT) versus fingolimod (Gilenya; Novartis), ocrelizumab (Ocrevus; Genentech) and natalizumab (Tysabri; Biogen) in a group of pairwise trials at the 2022 European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) Congress, held October 26-28, in Amsterdam, Netherlands.¹ Kalincik, professor of neurology and biostatistician at University of Melbourne and Royal Melbourne Hospital, and colleagues, recruited patients with relapsing-remitting multiple sclerosis (MS) from 6 AHSCT MS centers in Ottawa, Uppsala, Sheffield, Bergen, Sydney and Melbourne and combined their outcomes with patients from the MSBase registry.

In comparison, matched AHSCT-treated patients (n = 120) experienced less relapses than those on fingolimod (n = 612)(mean annualized relapse rate, 0.20 [±0.43] vs 0.11 [±0.36]; hazard ratio (HR) for relapses, 0.55, 95% CI, 0.37-0.91). Additionally, when comparing the 2 approaches, those treated with AHSCT demonstrated a similar risk of disability score worsening (HR, 0.49; 95% CI, 0.16-1.54) and higher chance of disability improvement (HR, 2.62; 95% CI, 1.46-4.72).¹

In an interview with NeurologyLive^®, Kalincik discussed the role of stem cell transplantation as it gains popularity within the MS field. He mentioned the greatest challenges faced, and also the progress previously made in terms of stem cell research and patients with MS.