ECTRIMS 2021 | BBB permeability changes predict treatment response to alemtuzumab in RRMS

Maria Højberg Knudsen, MD, PhD student, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark, shares the findings of a study looking at the utility of blood-brain barrier (BBB) permeability changes, measured by MRI, to predict treatment response to alemtuzumab in patients with multiple sclerosis (MS). Prior investigations in patients undergoing natalizumab or fingolimod treatment have demonstrated that BBB permeability at 6 months can predict the 2-year treatment response. Thus, prior to alemtuzumab initiation, 15 patients with relapsing-remitting MS underwent dynamic contrast-enhanced MRI to assess BBB permeability. Scans were repeated at 6, 12, and 18 months after first alemtuzumab dose and treatment response was determined according to the no evidence of disease activity-3 (NEDA-3) criteria at 2 years. The results showed that patients with NEDA status at 2 years showed a significantly greater decrease in BBB permeability from baseline to 6 months and 12 months, compared to those who had disease activity. In line with previous reports, these findings suggest BBB permeability may be used as an early marker of treatment response. This interview took place at the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) congress 2021.