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Lymphocyte reconstitution after DMF discontinuation in clinical trial and real-world patients with MS

Chan, Andrew; Rose, John; Alvarez, Enrique; Bar-Or, Amit; Butzkueven, Helmut; Fox, Robert J; Gold, Ralf; Gudesblatt, Mark; Haartsen, Jodi; Spelman, Tim; Wright, Katy; Ferraro, Diana; Sola, Patrizia; Hodgkinson, Suzanne; Kalincik, Tomas; Lechner-Scott, Jeannette; McGuigan, Christopher; Spach, Karen; Chen, Chongshu; Fam, Sami; Wu, Fan; Miller, Catherine
BACKGROUND:Delayed-release dimethyl fumarate (DMF) has demonstrated robust efficacy in treating patients with relapsing-remitting multiple sclerosis. Decreases in absolute lymphocyte count (ALC) are a well-known pharmacodynamic effect of DMF treatment, but lymphocyte recovery dynamics are not well characterized after discontinuation of DMF. METHODS:Data sources included the Biogen DMF integrated clinical trial data set, a retrospective US chart abstraction study, and data from MSBase. We assessed rate and time course of lymphocyte reconstitution after DMF discontinuation. RESULTS:/L was 12-18 months vs 2-3 months in patients with lymphopenia persisting <6 months. CONCLUSIONS:The majority of patients who discontinued DMF due to lymphopenia experienced ALC reconstitution within 2-4 months following DMF discontinuation. This may help guide clinicians in managing patients who develop lymphopenia during DMF treatment. Prolonged lymphopenia on DMF treatment is associated with slow lymphocyte recovery after DMF discontinuation.
PMCID:7837440
PMID: 33510947
ISSN: 2163-0402
CID: 5342282

Multiple sclerosis and cognitive impairment: computerized cognitive assessment and promis-cognitive function questionnaire: an unfulfilled promis [Meeting Abstract]

Kaczmarek, O.; Srinivasan, J.; Zarif, M.; Bumstead, B.; Buhse, M.; Golan, D.; Wilken, J.; Jaenicke, K.; Doroski, W.; Lund, D.; Gudesblatt, M.
ISI:000596547100344
ISSN: 1352-4585
CID: 5342822

Multiple Sclerosis Management: Predicting Disease Trajectory Of Multiple Sclerosis On Multi-dimensional Data Including Digital Cognitive Assessments And Patient Reported Outcomes Using Machine Learning Techniques [Meeting Abstract]

Srinivasan, J.; Gudesblatt, M.
ISI:000532412600212
ISSN: 1352-4585
CID: 5342722

Multiple Sclerosis Management And EDSS: A Great Start, But A Reason For Change Was Never So Apparent And Needed [Meeting Abstract]

Gudesblatt, M.; Srinivasan, J.; Bumstead, B.; Zarif, M.; Giovannoni, G.
ISI:000532412600070
ISSN: 1352-4585
CID: 5342702

The Association Between MRI Brain Volumes And Computerized Multi-domain Cognitive Scores Of People With Multiple Sclerosis [Meeting Abstract]

Golan, D.; Srinivasan, J.; Gudesblatt, M.
ISI:000532412600206
ISSN: 1352-4585
CID: 5342712

Efficacy of Diroximel Fumarate in Relapsing-Remitting MS Patients Who Are Newly Diagnosed or Previously Treated With Interferons or Glatiramer Acetate [Meeting Abstract]

Jasinska, E.; Wray, S.; Ziemssen, T.; Leigh-Pemberton, R.; Chen, H.; Kapadia, S.; Hanna, J.; Gudesblatt, M.
ISI:000534616801030
ISSN: 1351-5101
CID: 5342732

Quantitative MRI Brain Atrophy and IgG Subclass Profile: Cross Sectional Relationship In A Population of People with MS (PwMS) [Meeting Abstract]

Srinivasan, Jared; Dasaro, Christopher; Kaczmarek, Olivia; Bumstead, Barbara; Jaenicke, Kaitlyn; Buhse, Marijean; Golan, Daniel; Zarif, Myassar; Gudesblatt, Mark
ISI:000536058008066
ISSN: 0028-3878
CID: 5342742

The Association Between MRI Brain Volumes and Computerized Cognitive Scores of People with Multiple Sclerosis [Meeting Abstract]

Golan, Daniel; Srinivasan, Jared; Zarif, Myassar; Bumstead, Barbara; Buhse, Marijean; Fafard, Lori; Wilken, Jeffrey; Sullivan, Cynthia; Fratto, Timothy; VanVlierberghe, Eline; Sima, Diana; VanHecke, Wim; Gudesblatt, Mark
ISI:000536058008072
ISSN: 0028-3878
CID: 5342752

Analysis of association between expanded disability status scale and patient determined disease steps [Meeting Abstract]

Makin, C.; Altincatal, A.; Gudesblatt, M.; Kieseier, B.; De Moor, C.
ISI:000596547100255
ISSN: 1352-4585
CID: 5342812

Manual Dexterity and Computerized Cognitive Testing in People with Multiple Sclerosis: Motor Domain Reflects More Than Just What Is in the Hand [Meeting Abstract]

Srinivasan, Jared; Gudesblatt, Mark; Wilken, Jeffrey; Sullivan, Cynthia; Giannuzzi, Annina; Jawrower, Nicolas; Fafard, Lori; Bumstead, Barbara; Golan, Daniel
ISI:000468918500081
ISSN: 1352-4585
CID: 5344032