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Date of Graduation
12-12-2025
Semester of Graduation
Fall
Course Instructor
Laura Tice
Abstract
Objective: To perform an analysis of studies that assessed if autologous hematopoietic stem cell transplant (aHSCT) is more efficacious than monoclonal antibody (mAb) disease modifying treatment (DMT) in reducing Expanded Disability Score Status (EDSS) and thereby slowing disease progression in individuals diagnosed with Relapsing-Remitting Multiple Sclerosis (RRMS). Design: Systematic literature review. Methods: Initial systematic database searches were performed through PubMed. Secondary searches were performed via hand-searching techniques of multiple medical sources, such as the Journal of the American Medical Association (JAMA), the British Journal of Medicine (BMJ), and the Neurology Journal. Access was provided through the Library at James Madison University. Inclusion criteria were: original research performed within the last five years, and treatment regimens of aHSCT and monoclonal antibody (mAb) therapy in patients with RRMS. Results: The Burt et al. study found aHSCT prolonged progression of RRMS compared to DMT treatment. Zhukovsky et al. determined aHSCT treatment promoted “no evidence of disease activity” compared to DMTs. Kalincik et. al noted aHSCT therapy was superior in decreasing the severity and frequency of relapses compared to moderate-efficacy DMTs and one high-efficacy DMT; however, aHSCT was found to be non-inferior to a newer high-efficacy DMT. Conclusion: all three studies demonstrated the efficacious benefits of aHSCT therapy for patients with highly active RRMS, though further research is required for more direct comparisons to mAbs more recently approved for RRMS.
Recommended Citation
1. McKay KA, Kwan V , Duggan T, Tremlett H. Risk factors associated with the onset of relapsing-remitting and primary progressive multiple sclerosis: a systematic review. Biomed Res Int. 2015;2015:817238. doi:10.1155/2015/817238 2. Zanghì A, Galgani S, Bellantonio P, et al. Relapse-associated worsening in a real-life multiple sclerosis cohort: the role of age and pyramidal phenotype. Eur J Neurol. 2023;30(9):2736-2744. doi:10.1111/ene.15910 3. Helliwell CL, Coles AJ. Monoclonal antibodies in multiple sclerosis treatment: current and future steps. Ther Adv Neurol Disord. 2009;2(4):195-203. doi:10.1177/1756285609337827 4. Burt RK, Balabanov R, Burman J, et al. Effect of Nonmyeloablative Hematopoietic Stem Cell Transplantation vs Continued Disease-Modifying Therapy on Disease Progression in Patients With Relapsing-Remitting Multiple Sclerosis. JAMA. 2019;321(2):165. doi:https://doi.org/10.1001/jama.2018.18743 5. Kalincik T, Sharmin S, Roos I, et al. Comparative Effectiveness of Autologous Hematopoietic Stem Cell Transplant vs Fingolimod, Natalizumab, and Ocrelizumab in Highly Active Relapsing-Remitting Multiple Sclerosis. JAMA Neurology. 2023;80(7):702-702. doi:https://doi.org/10.1001/jamaneurol.2023.1184 6. Zhukovsky C, Sandgren S, Silfverberg T, et al. Autologous haematopoietic stem cell transplantation compared with alemtuzumab for relapsing–remitting multiple sclerosis: an observational study. Journal of Neurology, Neurosurgery and Psychiatry. 2021;92(2):189-194. doi:https://doi.org/10.1136/jnnp-2020-323992 7. Brittain G, Petrie J, Duffy KEM, et al. Efficacy and safety of autologous haematopoietic stem cell transplantation versus alemtuzumab, ocrelizumab, ofatumumab or cladribine in relapsing remitting multiple sclerosis (StarMS): protocol for a randomised controlled trial. BMJ Open. 2024;14(2):e083582. Published 2024 Feb 5. doi:10.1136/bmjopen-2023-083582 8. V oge NV , Alvarez E. Monoclonal Antibodies in Multiple Sclerosis: Present and Future. Biomedicines. 2019;7(1):20. Published 2019 Mar 14. doi:10.3390/biomedicines7010020
Poster
