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@article{Martin:2020:clinem/dgaa453,
author = {Martin, N and Sovetkina, A and Nadir, R and Scalfari, A and Tona, F and Murphy, K and Rigoni, E and Dorsey, R and Malik, O and Nandoskar, A and Singh-Curry, V and Nicholas, R},
doi = {clinem/dgaa453},
journal = {The Journal of Clinical Endocrinology & Metabolism},
pages = {e3392--e3399},
title = {Development of autoimmune thyroid disease in multiple sclerosis patients post-alemtuzumab improves treatment response},
url = {http://dx.doi.org/10.1210/clinem/dgaa453},
volume = {105},
year = {2020}
}

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TY  - JOUR
AB  - ContextAlemtuzumab is an anti-CD52 monoclonal antibody used in the treatment of relapsing-remitting multiple sclerosis (MS). Between 20-40% of alemtuzumab-treated MS patients develop autoimmune thyroid disease (AITD) as a side effect.ObjectiveTo determine whether MS disease progression following alemtuzumab treatment differs in patients that develop AITD compared to those who do not.Design, setting and patientsA retrospective analysis of 126 patients with relapsing-remitting MS receiving alemtuzumab from 2012 to 2017 at a tertiary referral centre.Main outcome measuresThyroid status, new relapses, Expanded Disability Status Score (EDSS) change and disability progression following alemtuzumab were evaluated.ResultsTwenty-six percent (33 out of 126, 25 female, 8 male) of alemtuzumab-treated patients developed AITD, 55% of which was Graves’ disease. EDSS score following alemtuzumab was reduced in patients who developed AITD compared to those who did not (median [IQR]; AITD: -0.25 [-1 - 0.5] vs non-AITD: 0 [1 - 0]. P=0.007]. Multivariate regression analysis confirmed that the development of AITD was independently associated with EDSS score improvement (p=0.011). Moreover, AITD patients had higher relapse-free survival following alemtuzumab (p=0.023). There was no difference in the number of new focal T2-lesions and contrast-enhancing MRI lesions developed following alemtuzumab between the two groups.ConclusionGraves’ disease was the most common form of AITD developed by MS patients following alemtuzumab. This study suggests that MS patients who develop AITD may have an improved response to alemtuzumab, as measured by reduced disability and lower relapse rate.
AU  - Martin,N
AU  - Sovetkina,A
AU  - Nadir,R
AU  - Scalfari,A
AU  - Tona,F
AU  - Murphy,K
AU  - Rigoni,E
AU  - Dorsey,R
AU  - Malik,O
AU  - Nandoskar,A
AU  - Singh-Curry,V
AU  - Nicholas,R
DO  - clinem/dgaa453
EP  - 3399
PY  - 2020///
SN  - 0021-972X
SP  - 3392
TI  - Development of autoimmune thyroid disease in multiple sclerosis patients post-alemtuzumab improves treatment response
T2  - The Journal of Clinical Endocrinology & Metabolism
UR  - http://dx.doi.org/10.1210/clinem/dgaa453
UR  - https://academic.oup.com/jcem/article/105/9/dgaa453/5872006
UR  - http://hdl.handle.net/10044/1/81405
VL  - 105
ER  -

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