Evidence map›Paper›PMID 30661133›Full record

Observational studyJournal of neurology2019

Treatment with alemtuzumab or rituximab after fingolimod withdrawal in relapsing-remitting multiple sclerosis is effective and safe.

Carmen Alcalá, F Gascón, Francisco Pérez-Miralles, J A Domínguez, S Gil-Perotín, B Casanova

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Journal of neurology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 5 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

14 citing papers in PubMed, 5 syntheses or guidelines pooled it.

  1. Pooled it
  2. Rituximab for people with multiple sclerosis.The Cochrane database of systematic reviews · 2025
    Pooled it
  3. Pooled it
  4. Pooled it
  5. Rituximab for people with multiple sclerosis.The Cochrane database of systematic reviews · 2021
    Pooled it
  6. Impact of Age on Switching or Stopping Disease Modifying Therapies in Multiple Sclerosis.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2025
    Review
  7. Article
  8. Article
  9. Article
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  11. Article
  12. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Carmen AlcaláDepartment of Neurology, La Fe Hospital, 106 Avenue Fernando Abril Martorell, 46026, Valencia, Spain. mc.alcalavicente@gmail.com.ORCID http://orcid.org/0000-0002-4799-7579
F GascónDepartment of Neurology, Clinic Hospital, Valencia, Spain.
Francisco Pérez-MirallesDepartment of Neurology, La Fe Hospital, 106 Avenue Fernando Abril Martorell, 46026, Valencia, Spain.
J A DomínguezDepartment of Neurology, Clinic Hospital, Valencia, Spain.
S Gil-PerotínDepartment of Neurology, La Fe Hospital, 106 Avenue Fernando Abril Martorell, 46026, Valencia, Spain.
B CasanovaDepartment of Neurology, La Fe Hospital, 106 Avenue Fernando Abril Martorell, 46026, Valencia, Spain.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIt has been described that treating relapsing-remitting multiple sclerosis (RRMS) patients with alemtuzumab following fingolimod could be less effective due to the different dynamics of lymphocyte repopulation. Effectiveness and safety of alemtuzumab compared to rituximab after fingolimod withdrawal were analyzed. PATIENTS AND

methodsA follow-up of a cohort of RRMS patients treated with alemtuzumab or rituximab after fingolimod withdrawal was accomplished. Effectiveness, measured by the percentage of patients with no evidence of disease activity (NEDA), and the presence of side effects (SE) were registered.

resultsFifty-five patients, 28 with alemtuzumab and 27 with rituximab, were analyzed. No differences in the washout period or in the baseline lymphocytes counts were observed. After a mean follow-up period of 28.8 months, the annualized relapsing rate was significantly reduced in the alemtuzumab group from 1.29 to 0.004 (p < 0.001) and in the rituximab group from 1.24 to 0.02 (p < 0.001), without differences. A significant reduction of the median EDSS from 2.8 to 2.0 in the alemtuzumab group and from 3.5 to 2.5 (p < 0.01) in the rituximab group was observed, without differences. Eighty-two per cent (n = 28) of patients in alemtuzumab group and 69.2% (n = 26) in rituximab group achieved NEDA criteria, without differences (p = 0.3). Symptoms related to the infusion were the most frequent SE in both groups. No serious SE were registered.

conclusionTreating RRMS patients with alemtuzumab or rituximab after fingolimod withdrawal is effective and safe, without significant differences between both groups in our series.

Indexed as

Outcome Assessment, Health CareAdultAlemtuzumabCohort StudiesFemaleFingolimod HydrochlorideHumansImmunologic FactorsMaleMiddle AgedMultiple Sclerosis, Relapsing-RemittingRituximabAlemtuzumabFingolimod HydrochlorideImmunologic FactorsRituximabAlemtuzumabFingolimod withdrawalLymphocyte repopulationRelapsing–remitting multiple sclerosisRituximabTreatment

Identifiers

PMID30661133

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.