ECTRIMS 2023 | AHSCT vs. high-activity DMTs in MS treatment

Antonio Scalfari, MD, PhD, Imperial College London, London, UK, delves into a single-center, head-to-head study comparing the real-world efficacy of autologous hematopoietic stem cell transplantation (AHSCT) against two high-activity disease-modifying treatments, alemtuzumab and ocrelizumab, for multiple sclerosis (MS). While AHSCT’s efficacy is acknowledged, its positioning in the treatment algorithm for MS remains debated. The study found AHSCT superior to alemtuzumab in preventing relapses and new MRI activity, but both treatments resulted in similar disability outcomes. When comparing AHSCT to ocrelizumab, differences in relapse rates and MRI outcomes were less pronounced. Dr Scalfari emphasizes that disability progression may be driven by mechanisms different from relapses. The study affirmed AHSCT’s safety profile with no unexpected side effects or procedure-related deaths. The importance of longer follow-ups, especially for ocrelizumab, was highlighted. This interview took place at the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) Congress 2023 in Milan, Italy.

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