Aggressive multiple sclerosis: a single‐centre, real‐world treatment experience with autologous haematopoietic stem cell transplantation and alemtuzumab

Background and purpose The best therapeutic approach for aggressive relapsing–remitting multiple sclerosis remains unknown. The objective was to compare the efficacy and safety of autologous haematopoietic stem cell transplantation (aHSCT) and alemtuzumab in aggressive relapsing–remitting multiple sclerosis. Methods The time to first relapse, time to confirmed disability worsening, time to first evidence of magnetic resonance imaging (MRI) activity and time to first evidence of disease activity were compared between the two treatment groups. Secondary outcomes included the 12, 24 and 36 month annualized relapse rate (ARR) and the 6‐month confirmed Expanded Disability Status Scale (EDSS) changes at months 12 and 24. Results Fifty‐seven patients treated with aHSCT (n = 25) or alemtuzumab (n = 32) were included. At baseline, aHSCT patients had a higher EDSS (median score 6 vs. 3; P