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


The professor of neurology and biostatistician at the University of Melbourne and Royal Melbourne Hospital spoke about his oral presentation from the 38th ECTRIMS Congress. [WATCH TIME: 5 minutes]

WATCH TIME: 5 minutes

“Probably the most striking feature that we observed was that in comparison to fingolimod and natalizumab, patients on [autologous hematopoietic stem cell transplantation] experienced much more frequent instances of improvement of disability, particularly during the first year after receiving the treatment.”

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.

1. Kalincik T, Sharman S, Roos I et al. Comparative effectiveness of autologous haematopoietic stem cell transplantation vs. fingolimod, ocrelizumab and natalizumab in relapsing-remitting MS. Presented at: 2022 ECTRIMS Congress; October 26-28; Amsterdam, Netherlands. Abstract 0019
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