Article

Key clinical point: H1-antihistamines (AH) may serve as potential adjuvants in preventing hepatocellular carcinoma (HCC) occurrence in patients with hepatitis B virus (HBV), hepatitis C virus (HCV), or dual HBV-HCV infection.

Main finding: AH use vs. nonuse led to a significantly reduced risk of HCC occurrence in patients infected with HBV (adjusted hazard ratio [aHR] 0.489; 95% CI 0.455-0.524), HCV (aHR 0.484; 95% CI 0.450-0.522), and dual HBV-HCV (aHR 0.469; 95% CI 0.416-0.529).

Study details: This was a retrospective cohort study involving adult patients with either HBV (n = 521,071), HCV (n = 169,159), or dual HBV-HCV (n = 39,016) infection, with each of the 3 cohorts including AH users (HBV, n = 127,398; HCV, n = 40,428; dual HBV-HCV, n =      8,661) and an equal number of non-AH users (<28 cumulative defined daily doses) after 1:1 individual matching.

Disclosures: The study was conducted with financial support from the Ministry of Science and Technology of the Republic of China and Taipei Medical University Hospital. The authors did not report any conflicts of interest.

Source: Shen YC et al. J Clin Oncol. 2022 (Jan 19). Doi: 10.1200/JCO.21.01802.

Key clinical point: H1-antihistamines (AH) may serve as potential adjuvants in preventing hepatocellular carcinoma (HCC) occurrence in patients with hepatitis B virus (HBV), hepatitis C virus (HCV), or dual HBV-HCV infection.

Main finding: AH use vs. nonuse led to a significantly reduced risk of HCC occurrence in patients infected with HBV (adjusted hazard ratio [aHR] 0.489; 95% CI 0.455-0.524), HCV (aHR 0.484; 95% CI 0.450-0.522), and dual HBV-HCV (aHR 0.469; 95% CI 0.416-0.529).

Study details: This was a retrospective cohort study involving adult patients with either HBV (n = 521,071), HCV (n = 169,159), or dual HBV-HCV (n = 39,016) infection, with each of the 3 cohorts including AH users (HBV, n = 127,398; HCV, n = 40,428; dual HBV-HCV, n =      8,661) and an equal number of non-AH users (<28 cumulative defined daily doses) after 1:1 individual matching.

Disclosures: The study was conducted with financial support from the Ministry of Science and Technology of the Republic of China and Taipei Medical University Hospital. The authors did not report any conflicts of interest.

Source: Shen YC et al. J Clin Oncol. 2022 (Jan 19). Doi: 10.1200/JCO.21.01802.

Key clinical point: H1-antihistamines (AH) may serve as potential adjuvants in preventing hepatocellular carcinoma (HCC) occurrence in patients with hepatitis B virus (HBV), hepatitis C virus (HCV), or dual HBV-HCV infection.

Main finding: AH use vs. nonuse led to a significantly reduced risk of HCC occurrence in patients infected with HBV (adjusted hazard ratio [aHR] 0.489; 95% CI 0.455-0.524), HCV (aHR 0.484; 95% CI 0.450-0.522), and dual HBV-HCV (aHR 0.469; 95% CI 0.416-0.529).

Study details: This was a retrospective cohort study involving adult patients with either HBV (n = 521,071), HCV (n = 169,159), or dual HBV-HCV (n = 39,016) infection, with each of the 3 cohorts including AH users (HBV, n = 127,398; HCV, n = 40,428; dual HBV-HCV, n =      8,661) and an equal number of non-AH users (<28 cumulative defined daily doses) after 1:1 individual matching.

Disclosures: The study was conducted with financial support from the Ministry of Science and Technology of the Republic of China and Taipei Medical University Hospital. The authors did not report any conflicts of interest.

Source: Shen YC et al. J Clin Oncol. 2022 (Jan 19). Doi: 10.1200/JCO.21.01802.

Key clinical point: Given its efficacy and safety as first-line therapy for advanced hepatocellular carcinoma (HCC), lenvatinib may serve as an alternative for patients with advanced
HCC and contraindications to immunotherapies.

Main finding: The median overall survival (12.8 months; 95% CI, 10.9-14.7 months) and progression-free survival (6.4 months; 95% CI, 5.1-7.7 months) achieved by lenvatinib in the real world were comparable with those reported by the phase 3 REFLECT trial (13.6 months and 7.4 months, respectively). Similarly, the percentage of patients showing grade 3 or higher adverse events (47.3%) was equivalent to that in REFLECT (56.7%).

Study details: The findings are derived from a real-world retrospective multicenter study, termed ELEVATOR, which included 205 patients with advanced HCC and no history of prior systemic therapy  and who received first-line therapy with lenvatinib.

Disclosures: The study was sponsored by Eisai. Some of the authors declared receiving speaker/advisor/consultant honoraria from various pharmaceutical companies including Eisai.

Source: Welland S et al. Liver Cancer. 2022 (Jan 14). Doi: 10.1159/000521746.

Key clinical point: Given its efficacy and safety as first-line therapy for advanced hepatocellular carcinoma (HCC), lenvatinib may serve as an alternative for patients with advanced
HCC and contraindications to immunotherapies.

Main finding: The median overall survival (12.8 months; 95% CI, 10.9-14.7 months) and progression-free survival (6.4 months; 95% CI, 5.1-7.7 months) achieved by lenvatinib in the real world were comparable with those reported by the phase 3 REFLECT trial (13.6 months and 7.4 months, respectively). Similarly, the percentage of patients showing grade 3 or higher adverse events (47.3%) was equivalent to that in REFLECT (56.7%).

Study details: The findings are derived from a real-world retrospective multicenter study, termed ELEVATOR, which included 205 patients with advanced HCC and no history of prior systemic therapy  and who received first-line therapy with lenvatinib.

Disclosures: The study was sponsored by Eisai. Some of the authors declared receiving speaker/advisor/consultant honoraria from various pharmaceutical companies including Eisai.

Source: Welland S et al. Liver Cancer. 2022 (Jan 14). Doi: 10.1159/000521746.

Key clinical point: Given its efficacy and safety as first-line therapy for advanced hepatocellular carcinoma (HCC), lenvatinib may serve as an alternative for patients with advanced
HCC and contraindications to immunotherapies.

Main finding: The median overall survival (12.8 months; 95% CI, 10.9-14.7 months) and progression-free survival (6.4 months; 95% CI, 5.1-7.7 months) achieved by lenvatinib in the real world were comparable with those reported by the phase 3 REFLECT trial (13.6 months and 7.4 months, respectively). Similarly, the percentage of patients showing grade 3 or higher adverse events (47.3%) was equivalent to that in REFLECT (56.7%).

Study details: The findings are derived from a real-world retrospective multicenter study, termed ELEVATOR, which included 205 patients with advanced HCC and no history of prior systemic therapy  and who received first-line therapy with lenvatinib.

Disclosures: The study was sponsored by Eisai. Some of the authors declared receiving speaker/advisor/consultant honoraria from various pharmaceutical companies including Eisai.

Source: Welland S et al. Liver Cancer. 2022 (Jan 14). Doi: 10.1159/000521746.

Key clinical point: Although using the triple biomarkers alpha-fetoprotein (AFP), Lens culinaris agglutinin-reactive fraction of AFP (AFP-L3), and des-gamma-carboxy prothrombin (DCP) in combination in the GALAD score is associated with increased sensitivity of hepatocellular carcinoma (HCC) diagnosis, the corresponding increase in false-positive results negates the advantage.

Main finding: Within 6, 12, and 24 months of HCC diagnosis, GALAD showed the highest true positive rate (TPR; 63.6%, 73.8%, and 71.4%, respectively) but a false positive rate (FPR) of 21.5%-22.9%; at a fixed 10% FPR, the TPR decreased (42.4%-46.9%), making the performance similar to that of AFP-L3 alone.

Study details: The findings are from a prospective cohort, phase 3 biomarker study including 534 patients with cirrhosis, but without present or past HCC, undergoing biannual HCC surveillance with liver imaging (ultrasound, computed tomography, or magnetic resonance imaging) and serum AFP. Of these patients, 50 progressed to develop HCC.

Disclosures: The study was sponsored by US National Institutes of
Health-National Cancer Institute, US National Institute of Diabetes and Digestive and Kidney Diseases, and Wako Inc. The authors declared having no conflicts of interest.

Source: Tayob N et al. Clin Gastroenterol Hepatol. 2022 (Feb 2). Doi: 10.1016/j.cgh.2022.01.047.

Key clinical point: Although using the triple biomarkers alpha-fetoprotein (AFP), Lens culinaris agglutinin-reactive fraction of AFP (AFP-L3), and des-gamma-carboxy prothrombin (DCP) in combination in the GALAD score is associated with increased sensitivity of hepatocellular carcinoma (HCC) diagnosis, the corresponding increase in false-positive results negates the advantage.

Main finding: Within 6, 12, and 24 months of HCC diagnosis, GALAD showed the highest true positive rate (TPR; 63.6%, 73.8%, and 71.4%, respectively) but a false positive rate (FPR) of 21.5%-22.9%; at a fixed 10% FPR, the TPR decreased (42.4%-46.9%), making the performance similar to that of AFP-L3 alone.

Study details: The findings are from a prospective cohort, phase 3 biomarker study including 534 patients with cirrhosis, but without present or past HCC, undergoing biannual HCC surveillance with liver imaging (ultrasound, computed tomography, or magnetic resonance imaging) and serum AFP. Of these patients, 50 progressed to develop HCC.

Disclosures: The study was sponsored by US National Institutes of
Health-National Cancer Institute, US National Institute of Diabetes and Digestive and Kidney Diseases, and Wako Inc. The authors declared having no conflicts of interest.

Source: Tayob N et al. Clin Gastroenterol Hepatol. 2022 (Feb 2). Doi: 10.1016/j.cgh.2022.01.047.

Key clinical point: Although using the triple biomarkers alpha-fetoprotein (AFP), Lens culinaris agglutinin-reactive fraction of AFP (AFP-L3), and des-gamma-carboxy prothrombin (DCP) in combination in the GALAD score is associated with increased sensitivity of hepatocellular carcinoma (HCC) diagnosis, the corresponding increase in false-positive results negates the advantage.

Main finding: Within 6, 12, and 24 months of HCC diagnosis, GALAD showed the highest true positive rate (TPR; 63.6%, 73.8%, and 71.4%, respectively) but a false positive rate (FPR) of 21.5%-22.9%; at a fixed 10% FPR, the TPR decreased (42.4%-46.9%), making the performance similar to that of AFP-L3 alone.

Study details: The findings are from a prospective cohort, phase 3 biomarker study including 534 patients with cirrhosis, but without present or past HCC, undergoing biannual HCC surveillance with liver imaging (ultrasound, computed tomography, or magnetic resonance imaging) and serum AFP. Of these patients, 50 progressed to develop HCC.

Disclosures: The study was sponsored by US National Institutes of
Health-National Cancer Institute, US National Institute of Diabetes and Digestive and Kidney Diseases, and Wako Inc. The authors declared having no conflicts of interest.

Source: Tayob N et al. Clin Gastroenterol Hepatol. 2022 (Feb 2). Doi: 10.1016/j.cgh.2022.01.047.

Key clinical point: Perioperative programmed cell death protein 1 blockade via neoadjuvant cemiplimab monotherapy may offer survival benefit in patients with resectable hepatocellular carcinoma (HCC) without compromising on safety.

Main finding: Significant (>70%) tumor necrosis was observed in 20% of patients who underwent successful resection, of which 15% showed complete (100%) tumor necrosis. Grade 3 adverse events were observed in 33% of patients, whereas no grade 4/5 adverse events were noted.

Study details: The preliminary data are derived from a single-center phase 2 trial involving 21 adult patients with resectable HCC who received 2 doses of cemiplimab followed by surgical resection.

Disclosures: This study was sponsored by Regeneron Pharmaceuticals. Some of the authors, including the lead author, declared receiving research funds from or serving as an employee and shareholder, consultant, or advisor for various organizations including Regeneron Pharmaceuticals.

Source: Marron TU et al. Lancet Gastroenterol Hepatol. 2022;7(3):P219-29 (Jan 19). Doi: 10.1016/S2468-1253(21)00385-X.

Key clinical point: Perioperative programmed cell death protein 1 blockade via neoadjuvant cemiplimab monotherapy may offer survival benefit in patients with resectable hepatocellular carcinoma (HCC) without compromising on safety.

Main finding: Significant (>70%) tumor necrosis was observed in 20% of patients who underwent successful resection, of which 15% showed complete (100%) tumor necrosis. Grade 3 adverse events were observed in 33% of patients, whereas no grade 4/5 adverse events were noted.

Study details: The preliminary data are derived from a single-center phase 2 trial involving 21 adult patients with resectable HCC who received 2 doses of cemiplimab followed by surgical resection.

Disclosures: This study was sponsored by Regeneron Pharmaceuticals. Some of the authors, including the lead author, declared receiving research funds from or serving as an employee and shareholder, consultant, or advisor for various organizations including Regeneron Pharmaceuticals.

Source: Marron TU et al. Lancet Gastroenterol Hepatol. 2022;7(3):P219-29 (Jan 19). Doi: 10.1016/S2468-1253(21)00385-X.

Key clinical point: Perioperative programmed cell death protein 1 blockade via neoadjuvant cemiplimab monotherapy may offer survival benefit in patients with resectable hepatocellular carcinoma (HCC) without compromising on safety.

Main finding: Significant (>70%) tumor necrosis was observed in 20% of patients who underwent successful resection, of which 15% showed complete (100%) tumor necrosis. Grade 3 adverse events were observed in 33% of patients, whereas no grade 4/5 adverse events were noted.

Study details: The preliminary data are derived from a single-center phase 2 trial involving 21 adult patients with resectable HCC who received 2 doses of cemiplimab followed by surgical resection.

Disclosures: This study was sponsored by Regeneron Pharmaceuticals. Some of the authors, including the lead author, declared receiving research funds from or serving as an employee and shareholder, consultant, or advisor for various organizations including Regeneron Pharmaceuticals.

Source: Marron TU et al. Lancet Gastroenterol Hepatol. 2022;7(3):P219-29 (Jan 19). Doi: 10.1016/S2468-1253(21)00385-X.

Key clinical point: In addition to being safe, perioperative administration of nivolumab with or without ipilimumab may elicit a major response with longer recurrence-free survival in patients with resectable hepatocellular carcinoma (HCC).

Main finding: Grade 3/4 treatment-related adverse events were observed in 43% and 23% of patients with nivolumab+ipilimumab and nivolumab alone, respectively (P = .69). Of the patients who underwent surgery, nivolumab alone and nivolumab+ipilimumab caused a major pathology-related response in 33% (95% CI 7.5%-70.1%) and 27% (95% CI 6%-61%), respectively, who showed improved recurrence-free survival vs. those with no pathological response (log-rank P = .049).

Study details: This was a single-center, phase 2 trial including 27 adult patients with resectable HCC who were randomly assigned to receive nivolumab alone (n = 13) or nivolumab plus ipilimumab (n = 14) before and after partial hepatectomy.

Disclosures: The study was sponsored by Bristol Myers Squibb (BMS) and the US National Institutes of Health. A few authors, including the lead author, served as a consultants/advisors or were stock owners of and received research funding/honoraria from numerous organizations including BMS.

Source: Kaseb AO et al. Lancet Gastroenterol Hepatol. 2022;7(3):P208-18 (Jan 19). Doi: 10.1016/S2468-1253(21)00427-1.

Key clinical point: In addition to being safe, perioperative administration of nivolumab with or without ipilimumab may elicit a major response with longer recurrence-free survival in patients with resectable hepatocellular carcinoma (HCC).

Main finding: Grade 3/4 treatment-related adverse events were observed in 43% and 23% of patients with nivolumab+ipilimumab and nivolumab alone, respectively (P = .69). Of the patients who underwent surgery, nivolumab alone and nivolumab+ipilimumab caused a major pathology-related response in 33% (95% CI 7.5%-70.1%) and 27% (95% CI 6%-61%), respectively, who showed improved recurrence-free survival vs. those with no pathological response (log-rank P = .049).

Study details: This was a single-center, phase 2 trial including 27 adult patients with resectable HCC who were randomly assigned to receive nivolumab alone (n = 13) or nivolumab plus ipilimumab (n = 14) before and after partial hepatectomy.

Disclosures: The study was sponsored by Bristol Myers Squibb (BMS) and the US National Institutes of Health. A few authors, including the lead author, served as a consultants/advisors or were stock owners of and received research funding/honoraria from numerous organizations including BMS.

Source: Kaseb AO et al. Lancet Gastroenterol Hepatol. 2022;7(3):P208-18 (Jan 19). Doi: 10.1016/S2468-1253(21)00427-1.

Key clinical point: In addition to being safe, perioperative administration of nivolumab with or without ipilimumab may elicit a major response with longer recurrence-free survival in patients with resectable hepatocellular carcinoma (HCC).

Main finding: Grade 3/4 treatment-related adverse events were observed in 43% and 23% of patients with nivolumab+ipilimumab and nivolumab alone, respectively (P = .69). Of the patients who underwent surgery, nivolumab alone and nivolumab+ipilimumab caused a major pathology-related response in 33% (95% CI 7.5%-70.1%) and 27% (95% CI 6%-61%), respectively, who showed improved recurrence-free survival vs. those with no pathological response (log-rank P = .049).

Study details: This was a single-center, phase 2 trial including 27 adult patients with resectable HCC who were randomly assigned to receive nivolumab alone (n = 13) or nivolumab plus ipilimumab (n = 14) before and after partial hepatectomy.

Disclosures: The study was sponsored by Bristol Myers Squibb (BMS) and the US National Institutes of Health. A few authors, including the lead author, served as a consultants/advisors or were stock owners of and received research funding/honoraria from numerous organizations including BMS.

Source: Kaseb AO et al. Lancet Gastroenterol Hepatol. 2022;7(3):P208-18 (Jan 19). Doi: 10.1016/S2468-1253(21)00427-1.

Key clinical point: Patients with multiple sclerosis (pwMS) who participated in a web-based mindfulness-based intervention (MBI) showed significant improvements in depressive symptoms and health-related quality of life (HRQoL).

Major finding: The MBI group showed a significant improvement in depressive symptoms compared with the waitlist (Cohen’s d 0.39; 95% CI, 0.034-0.742), with patients with recurrent depressive symptoms benefitting the most (P = .034). MBI had a positive effect on HRQoL regardless of previous depressive history (P = .009).

Study details: The findings come from a randomized controlled trial involving 132 pwMS with or without a history of recurrent depression, and who received either an internet-delivered MBI (n = 69) or were assigned to a waitlist (n = 63).

Disclosures: This study was supported by the National Health and Medical Research Council and Multiple Sclerosis Research, Australia. The authors declared no conflict of interests.

Source: Sesel AL et al. Mult Scler. 2022 (Feb 7). Doi:  10.1177/13524585211068002.

Key clinical point: Patients with multiple sclerosis (pwMS) who participated in a web-based mindfulness-based intervention (MBI) showed significant improvements in depressive symptoms and health-related quality of life (HRQoL).

Major finding: The MBI group showed a significant improvement in depressive symptoms compared with the waitlist (Cohen’s d 0.39; 95% CI, 0.034-0.742), with patients with recurrent depressive symptoms benefitting the most (P = .034). MBI had a positive effect on HRQoL regardless of previous depressive history (P = .009).

Study details: The findings come from a randomized controlled trial involving 132 pwMS with or without a history of recurrent depression, and who received either an internet-delivered MBI (n = 69) or were assigned to a waitlist (n = 63).

Disclosures: This study was supported by the National Health and Medical Research Council and Multiple Sclerosis Research, Australia. The authors declared no conflict of interests.

Source: Sesel AL et al. Mult Scler. 2022 (Feb 7). Doi:  10.1177/13524585211068002.

Key clinical point: Patients with multiple sclerosis (pwMS) who participated in a web-based mindfulness-based intervention (MBI) showed significant improvements in depressive symptoms and health-related quality of life (HRQoL).

Major finding: The MBI group showed a significant improvement in depressive symptoms compared with the waitlist (Cohen’s d 0.39; 95% CI, 0.034-0.742), with patients with recurrent depressive symptoms benefitting the most (P = .034). MBI had a positive effect on HRQoL regardless of previous depressive history (P = .009).

Study details: The findings come from a randomized controlled trial involving 132 pwMS with or without a history of recurrent depression, and who received either an internet-delivered MBI (n = 69) or were assigned to a waitlist (n = 63).

Disclosures: This study was supported by the National Health and Medical Research Council and Multiple Sclerosis Research, Australia. The authors declared no conflict of interests.

Source: Sesel AL et al. Mult Scler. 2022 (Feb 7). Doi:  10.1177/13524585211068002.

Key clinical point: A significant reduction in absolute lymphocyte counts (ALC) early after the initiation of dimethyl fumarate (DMF) was strongly associated with the development of severe lymphopenia in patients with relapsing multiple sclerosis (MS).

Major finding: A decline in mean ALC of ≥21.2% within the first 3 months of treatment increased the risk for DMF associated-lymphopenia by 6.5-fold (adjusted hazard risk [aHR] 6.503), whereas a decline of ≥40.2% increased the risk for severe lymphopenia by 12.67-fold (aHR 12.67; both P < .001).

Study details: The findings come from a multicenter, noninterventional, prospective real-world study involving 532 patients with relapsing MS who initiated taking DMF.

Disclosures: No funding was received for conducting this study. The authors, including the lead author, declared serving on the advisory board or receiving research/travel grants and speaker/consultancy fees from various sources.

Source: Sainz de la Maza S et al. Mult Scler Relat Disor. 2022;59:103669 (Feb 4). Doi:  10.1016/j.msard.2022.103669.

Key clinical point: A significant reduction in absolute lymphocyte counts (ALC) early after the initiation of dimethyl fumarate (DMF) was strongly associated with the development of severe lymphopenia in patients with relapsing multiple sclerosis (MS).

Major finding: A decline in mean ALC of ≥21.2% within the first 3 months of treatment increased the risk for DMF associated-lymphopenia by 6.5-fold (adjusted hazard risk [aHR] 6.503), whereas a decline of ≥40.2% increased the risk for severe lymphopenia by 12.67-fold (aHR 12.67; both P < .001).

Study details: The findings come from a multicenter, noninterventional, prospective real-world study involving 532 patients with relapsing MS who initiated taking DMF.

Disclosures: No funding was received for conducting this study. The authors, including the lead author, declared serving on the advisory board or receiving research/travel grants and speaker/consultancy fees from various sources.

Source: Sainz de la Maza S et al. Mult Scler Relat Disor. 2022;59:103669 (Feb 4). Doi:  10.1016/j.msard.2022.103669.

Key clinical point: A significant reduction in absolute lymphocyte counts (ALC) early after the initiation of dimethyl fumarate (DMF) was strongly associated with the development of severe lymphopenia in patients with relapsing multiple sclerosis (MS).

Major finding: A decline in mean ALC of ≥21.2% within the first 3 months of treatment increased the risk for DMF associated-lymphopenia by 6.5-fold (adjusted hazard risk [aHR] 6.503), whereas a decline of ≥40.2% increased the risk for severe lymphopenia by 12.67-fold (aHR 12.67; both P < .001).

Study details: The findings come from a multicenter, noninterventional, prospective real-world study involving 532 patients with relapsing MS who initiated taking DMF.

Disclosures: No funding was received for conducting this study. The authors, including the lead author, declared serving on the advisory board or receiving research/travel grants and speaker/consultancy fees from various sources.

Source: Sainz de la Maza S et al. Mult Scler Relat Disor. 2022;59:103669 (Feb 4). Doi:  10.1016/j.msard.2022.103669.

Key clinical point: The time to confirmed disability progression (CDP) and serum neurofilament light chain levels (sNfL) was not significantly different in patients with primary progressive multiple sclerosis (pwPPMS), who received treatment with rituximab or ocrelizumab.

Major finding: After a mean follow-up of 18.3 months, rituximab vs. ocrelizumab groups showed no significant difference in the proportion of patients with CDP (30.6% vs. 23.9%; P = .356). The mean sNfL level was not significantly different between the groups (P = .192).

Study details: The findings come from a multicentric observational study involving 111 pwPPMS who started treatment with ocrelizumab or rituximab.

Disclosures: This study was supported by the Health Institute Carlos III and FEDER funding. Four authors reported receiving travel grants and consulting/speaker fees from various sources.

Source: Alcalá C et al. J Neurol. 2022 (Feb 2). Doi: 10.1007/s00415-022-10989-0

Key clinical point: The time to confirmed disability progression (CDP) and serum neurofilament light chain levels (sNfL) was not significantly different in patients with primary progressive multiple sclerosis (pwPPMS), who received treatment with rituximab or ocrelizumab.

Major finding: After a mean follow-up of 18.3 months, rituximab vs. ocrelizumab groups showed no significant difference in the proportion of patients with CDP (30.6% vs. 23.9%; P = .356). The mean sNfL level was not significantly different between the groups (P = .192).

Study details: The findings come from a multicentric observational study involving 111 pwPPMS who started treatment with ocrelizumab or rituximab.

Disclosures: This study was supported by the Health Institute Carlos III and FEDER funding. Four authors reported receiving travel grants and consulting/speaker fees from various sources.

Source: Alcalá C et al. J Neurol. 2022 (Feb 2). Doi: 10.1007/s00415-022-10989-0

Key clinical point: The time to confirmed disability progression (CDP) and serum neurofilament light chain levels (sNfL) was not significantly different in patients with primary progressive multiple sclerosis (pwPPMS), who received treatment with rituximab or ocrelizumab.

Major finding: After a mean follow-up of 18.3 months, rituximab vs. ocrelizumab groups showed no significant difference in the proportion of patients with CDP (30.6% vs. 23.9%; P = .356). The mean sNfL level was not significantly different between the groups (P = .192).

Study details: The findings come from a multicentric observational study involving 111 pwPPMS who started treatment with ocrelizumab or rituximab.

Disclosures: This study was supported by the Health Institute Carlos III and FEDER funding. Four authors reported receiving travel grants and consulting/speaker fees from various sources.

Source: Alcalá C et al. J Neurol. 2022 (Feb 2). Doi: 10.1007/s00415-022-10989-0

Key clinical point: Changes in serum neurofilament light chain (sNfL) may not be a dynamic biomarker related to confirmed disability progression (CDP) in patients with secondary progressive multiple sclerosis (SPMS) without acute inflammation.

Major finding: At 48 weeks, changes in sNfL were not associated with the risk for CDP in the natalizumab (odds ratio [OR] per 10% increase in sNfL 1.02; 95% CI 0.86-1.21) and placebo (OR per 10% increase in sNfL 0.90; 95% CI 0.64-1.27) groups.

Study details: The findings come from a post hoc analysis of the ASCEND trial involving 317 patients with SPMS without acute inflammation who were randomly assigned to receive either natalizumab (n = 214) or placebo (n = 103).

Disclosures: This study was supported by Biogen. Dr. Zetterberg and Dr. Fox reported receiving personal fees or research contracts from various sources including Biogen. Dr. Belachew reported being an employee and shareholder of Biogen.

Source: Gafson AR et al. JAMA Netw Open. 2022;5(2):e2147588 (Feb 8). Doi:  10.1001/jamanetworkopen.2021.47588

Key clinical point: Changes in serum neurofilament light chain (sNfL) may not be a dynamic biomarker related to confirmed disability progression (CDP) in patients with secondary progressive multiple sclerosis (SPMS) without acute inflammation.

Major finding: At 48 weeks, changes in sNfL were not associated with the risk for CDP in the natalizumab (odds ratio [OR] per 10% increase in sNfL 1.02; 95% CI 0.86-1.21) and placebo (OR per 10% increase in sNfL 0.90; 95% CI 0.64-1.27) groups.

Study details: The findings come from a post hoc analysis of the ASCEND trial involving 317 patients with SPMS without acute inflammation who were randomly assigned to receive either natalizumab (n = 214) or placebo (n = 103).

Disclosures: This study was supported by Biogen. Dr. Zetterberg and Dr. Fox reported receiving personal fees or research contracts from various sources including Biogen. Dr. Belachew reported being an employee and shareholder of Biogen.

Source: Gafson AR et al. JAMA Netw Open. 2022;5(2):e2147588 (Feb 8). Doi:  10.1001/jamanetworkopen.2021.47588

Key clinical point: Changes in serum neurofilament light chain (sNfL) may not be a dynamic biomarker related to confirmed disability progression (CDP) in patients with secondary progressive multiple sclerosis (SPMS) without acute inflammation.

Major finding: At 48 weeks, changes in sNfL were not associated with the risk for CDP in the natalizumab (odds ratio [OR] per 10% increase in sNfL 1.02; 95% CI 0.86-1.21) and placebo (OR per 10% increase in sNfL 0.90; 95% CI 0.64-1.27) groups.

Study details: The findings come from a post hoc analysis of the ASCEND trial involving 317 patients with SPMS without acute inflammation who were randomly assigned to receive either natalizumab (n = 214) or placebo (n = 103).

Disclosures: This study was supported by Biogen. Dr. Zetterberg and Dr. Fox reported receiving personal fees or research contracts from various sources including Biogen. Dr. Belachew reported being an employee and shareholder of Biogen.

Source: Gafson AR et al. JAMA Netw Open. 2022;5(2):e2147588 (Feb 8). Doi:  10.1001/jamanetworkopen.2021.47588

Key clinical point: Both elevated levels of baseline serum neurofilament light chain (sNfL) and increasing levels from a low baseline were associated with multiple sclerosis (MS) relapses, indicating the utility of sNfL in identifying patients who may benefit from early treatment optimization.

Major finding: A 2-fold increase in baseline sNfL was associated with a 1.9-fold increased risk for relapse during follow-up (adjusted hazard ratio [aHR] 1.90; P < .01) and a 2-fold longitudinal increase in sNfL from its first measurement increased the risk for relapse by 1.41-fold (aHR 1.41; P = .04).

Study details: Findings are from an analysis of 58 patients with active MS who were prospectively followed for 1 year as a part of clinical trial.

Disclosures: This study received funding from the MS Society of Canada, Fondazione Italiana Sclerosi Multipla, and Research Manitoba. The authors reported no conflict of interests.

Source: Thebault S et al. Mult Scler Relat Disord. 2022;59:103535 (Jan 18). Doi:  10.1016/j.msard.2022.103535

Key clinical point: Both elevated levels of baseline serum neurofilament light chain (sNfL) and increasing levels from a low baseline were associated with multiple sclerosis (MS) relapses, indicating the utility of sNfL in identifying patients who may benefit from early treatment optimization.

Major finding: A 2-fold increase in baseline sNfL was associated with a 1.9-fold increased risk for relapse during follow-up (adjusted hazard ratio [aHR] 1.90; P < .01) and a 2-fold longitudinal increase in sNfL from its first measurement increased the risk for relapse by 1.41-fold (aHR 1.41; P = .04).

Study details: Findings are from an analysis of 58 patients with active MS who were prospectively followed for 1 year as a part of clinical trial.

Disclosures: This study received funding from the MS Society of Canada, Fondazione Italiana Sclerosi Multipla, and Research Manitoba. The authors reported no conflict of interests.

Source: Thebault S et al. Mult Scler Relat Disord. 2022;59:103535 (Jan 18). Doi:  10.1016/j.msard.2022.103535

Key clinical point: Both elevated levels of baseline serum neurofilament light chain (sNfL) and increasing levels from a low baseline were associated with multiple sclerosis (MS) relapses, indicating the utility of sNfL in identifying patients who may benefit from early treatment optimization.

Major finding: A 2-fold increase in baseline sNfL was associated with a 1.9-fold increased risk for relapse during follow-up (adjusted hazard ratio [aHR] 1.90; P < .01) and a 2-fold longitudinal increase in sNfL from its first measurement increased the risk for relapse by 1.41-fold (aHR 1.41; P = .04).

Study details: Findings are from an analysis of 58 patients with active MS who were prospectively followed for 1 year as a part of clinical trial.

Disclosures: This study received funding from the MS Society of Canada, Fondazione Italiana Sclerosi Multipla, and Research Manitoba. The authors reported no conflict of interests.

Source: Thebault S et al. Mult Scler Relat Disord. 2022;59:103535 (Jan 18). Doi:  10.1016/j.msard.2022.103535