Real-world data on eculizumab treatment in NMOSD: high efficacy and potential challenges (P13-5.017)

医学 伊库利珠单抗 视神经脊髓炎 儿科 内科学 耐受性 强的松 无症状的 免疫学 不利影响 多发性硬化 抗体 补体系统
作者
Ilya Ayzenberg,Susanna Asseyer,Gero Lindenblatt,Katinka Fischer,Refik Pul,Sinem-Hilal Oezalp,Lisa Lohmann,Katrin Giglhuber,Vivien Häußler,Michael Karenfort,Kerstin Hellwig,Friedemann Paul,Judith Bellmann‐Strobl,Carolin Otto,Klemens Ruprecht,Tjalf Ziemssen,Alexander Emmer,Veit Rothhammer,Florian T. Nickel,Klemens Angstwurm,Ralf A. Linker,Clemens Warnke,Sven Jarius,Mirjam Korporal‐Kuhnke,Brigitte Wildemann,S Wolff,Maria Seipelt,Yavor Yalachkov,Nele Retzlaff,Uwe K. Zettl,Paulus Rommer,Markus C. Kowarik,Jonathan Wickel,Christian Geis,Martin W. Hümmert,Corinna Trebst,Makbule Şenel,Luisa Klotz,Ralf Gold,Christoph Kleinschnitz,Sven G. Meuth,Orhan Aktaş,Achim Berthele,Marius Ringelstein
出处
期刊:Neurology [Ovid Technologies (Wolters Kluwer)]
卷期号:100 (17_supplement_2) 被引量:1
标识
DOI:10.1212/wnl.0000000000203153
摘要

Objective:

To evaluate efficacy and safety of eculizumab (ECU) in a large real-world Neuromyelitis optica spectrum disorder (NMOSD) cohort.

Background:

Real-world data on Eculizumab in NMOSD are still scarce. The drug was highly effective in preventing relapses in the phase-III PREVENT trial and is approved for AQP4-IgG+ NMOSD, but carries potential risk of life-threatening meningococcal infection. Therefore, appropriate vaccination or antibiotic prophylaxis are mandatory.

Design/Methods:

In this retrospective multicenter study we analyzed annualized relapse rate (ARR), disability (EDSS) and rate of serious infections during ECU, as well as tolerability of meningococcal vaccination.

Results:

55 patients (52 AQP4-IgG+, 84% female, 48.6±16.6 years) with an active NMOSD (median ARR 1.0, EDSS 6.0) were included. 13/55 were treatment-naive and 42/55 switched from another immunotherapy. 38/55 experienced a relapse or asymptomatic MRI activity <3 months before ECU. During ECU-treatment (17.4±15.4 months) ARR dropped significantly (from 1.0(0–3.0) to 0(0–1.4), p<0.001), 86% of patients were relapse-free. The median EDSS remained stable. 39/55 patients received at least one meningococcal vaccination prior-to-ECU, resulting in a significant treatment delay comparing to those with antibiotic prophylaxis. 9/39 patients have been vaccinated despite concomitant oral prednisone and reported no relapses. In contrast 10/30 (33%) patients vaccinated prior-to-ECU without prednisone experienced new attacks shortly thereafter (interval 9.5±7.7 days). None of 24/55 vaccinated during ECU relapsed during following 4 weeks. Despite vaccination one patient developed meningococcal sepsis, 4 other multimorbid patients experienced non-meningococcal systemic infections. Five patients died during ECU, three in the context of sepsis and two due to myocardial infarction and ileus, respectively. Ten further patients discontinuated ECU due to different reasons.

Conclusions:

Real-world data confirm high efficacy of eculizumab in NMOSD. Risk of relapses in patients vaccinated prior to eculizumab start and potential severe infections in multimorbid patients must be considered. Further studies are needed to establish an optimal vaccination schedule in active NMOSD. Disclosure: Dr. Ayzenberg has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Ayzenberg has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Dr. Ayzenberg has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi Aventis. Dr. Ayzenberg has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Ayzenberg has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon. Dr. Ayzenberg has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Alexion. Dr. Ayzenberg has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. Dr. Ayzenberg has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Merck. The institution of Dr. Ayzenberg has received research support from Diamed. Dr. Asseyer has received personal compensation in the range of $0-$499 for serving as a speaker with Alexion. Dr. Asseyer has received personal compensation in the range of $0-$499 for serving as a speaker with Roche Pharma AG. Dr. Asseyer has received personal compensation in the range of $0-$499 for serving as a speaker with Bayer AG. Mr. Lindenblatt has nothing to disclose. Ms. Fischer has nothing to disclose. Refik Pul has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alexion, BMS, Hexal, Horizon, Janssen, Merck, Novartis, Sanofi . Refik Pul has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion, BMS, Hexal, Horizon, Janssen, Merck, Novartis, Sanofi . Ms. Oezalp has nothing to disclose. Lisa Lohmann has nothing to disclose. Katrin Giglhuber has nothing to disclose. Mrs. Haeussler has nothing to disclose. Dr. Karenfort has nothing to disclose. Kerstin Hellwig has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Teva . Kerstin Hellwig has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen . Kerstin Hellwig has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis . Kerstin Hellwig has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche . Kerstin Hellwig has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck . Kerstin Hellwig has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genzyme . Kerstin Hellwig has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bayer . Kerstin Hellwig has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BMS. Kerstin Hellwig has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Janssen . Kerstin Hellwig has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for INC research . Kerstin Hellwig has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis . Kerstin Hellwig has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche . Kerstin Hellwig has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Merck . Kerstin Hellwig has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen . Kerstin Hellwig has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bayer . The institution of Kerstin Hellwig has received research support from Roche . The institution of Kerstin Hellwig has received research support from Merck . The institution of Kerstin Hellwig has received research support from Biogen. The institution of Kerstin Hellwig has received research support from Genzyme . The institution of Kerstin Hellwig has received research support from Novartis . The institution of Kerstin Hellwig has received research support from TEVA. The institution of Dr. Paul has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Mitsubishi Tanabe PC (MTPC). The institution of Dr. Paul has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Aarhus University. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Paul has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi Genzyme. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for UCB Pharma. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for CELGENE. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bayer. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for ACRELION. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Viela Bio. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Alexion. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Pfizter. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Merck Serono. The institution of Dr. Paul has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Springer. Judith Bellmann-Strobl, MD has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Judith Bellmann-Strobl, MD has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Judith Bellmann-Strobl, MD has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi Genzyme. Judith Bellmann-Strobl, MD has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. The institution of Judith Bellmann-Strobl, MD has received research support from Bayer. The institution of Judith Bellmann-Strobl, MD has received research support from NEMOS. Dr. Otto has nothing to disclose. Dr. Ruprecht has received research support from European Union (821283-2). Dr. Ruprecht has received research support from Merck Serono. Dr. Ruprecht has received research support from Stiftung Charite. Dr. Ruprecht has received research support from Arthur Arnstein Foundation. Dr. Ruprecht has received publishing royalties from a publication relating to health care. Dr. Ziemssen has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. Dr. Ziemssen has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Roche. Dr. Ziemssen has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis. Dr. Ziemssen has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for BMS Celgene. Dr. Ziemssen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. Dr. Ziemssen has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Roche. Dr. Ziemssen has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Novartis. Dr. Ziemssen has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Merck. Dr. Ziemssen has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Sanofi. Dr. Ziemssen has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for BMS Celgene. Dr. Ziemssen has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Biogen. Dr. Ziemssen has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for TEVA. The institution of Dr. Ziemssen has received research support from Biogen. The institution of Dr. Ziemssen has received research support from Novartis. The institution of Dr. Ziemssen has received research support from Merck. The institution of Dr. Ziemssen has received research support from Sanofi. The institution of Dr. Ziemssen has received research support from Celgene. Dr. Emmer has nothing to disclose. Prof. Rothhammer has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Prof. Rothhammer has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. The institution of Prof. Rothhammer has received research support from German Research Foundation. The institution of Prof. Rothhammer has received research support from European Research Council. Florian Nickel has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Florian Nickel has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Janssen. Florian Nickel has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck Serono. Florian Nickel has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Florian Nickel has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen. Florian Nickel has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for BMS. Dr. Angstwurm has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. Angstwurm has received personal compensation in the range of $500-$4,999 for serving as a Consultant for TEVA. Dr. Linker has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Linker has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Springer. The institution of Dr. Linker has received research support from Novartis. The institution of Dr. Linker has received research support from Biogen. The institution of Clemens Warnke has received research support from Novartis. The institution of Clemens Warnke has received research support from Alexion. The institution of Clemens Warnke has received research support from Sanofi-Genzyme. The institution of Clemens Warnke has received research support from Biogen. The institution of Clemens Warnke has received research support from Roche. Dr. Jarius has nothing to disclose. Dr. Korporal-Kuhnke has nothing to disclose. Dr. Wildemann has nothing to disclose. Dr. Wolff has nothing to disclose. Maria Seipelt has nothing to disclose. The institution of Yavor Yalachkov has received research support from Heinrich und Erna Schaufler-Stiftung. Yavor Yalachkov has received personal compensation in the range of $0-$499 for serving as a Lecturer with The Medical Association of Hesse. Yavor Yalachkov has received personal compensation in the range of $0-$499 for serving as a Speaker with RG Gesellschaft für Information und Organisation mbH. Yavor Yalachkov has received personal compensation in the range of $500-$4,999 for serving as a Speaker with Roche. Mrs. Retzlaff has nothing to disclose. Uwe Zettl has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Merck Serono. Uwe Zettl has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Alexion . Uwe Zettl has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bayer. Uwe Zettl has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. Uwe Zettl has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Teva. The institution of Uwe Zettl has received research support from BMBF(Government). Dr. Rommer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alexion. Dr. Rommer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Rommer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for biogen. The institution of Dr. Rommer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for celgene. The institution of Dr. Rommer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for merck. Dr. Rommer has received personal compensation in the range of $0-$499 for serving as a Consultant for sanofi. Dr. Rommer has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for sandoz. Dr. Rommer has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Abbvie. Dr. Rommer has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for almirall. Dr. Rommer has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for biogen. Dr. Rommer has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Dr. Rommer has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Merck. The institution of Dr. Rommer has received research support from merck. The institution of Dr. Rommer has received research support from roche. The institution of Dr. Rommer has received research support from amicus. The institution of Dr. Rommer has received research support from biogen. Markus Kowarik has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck, Roche, Celgene, Sanofi-Genzyme, Novartis and Biogen. The institution of Markus Kowarik has received research support from Merck. The institution of Markus Kowarik has received research support from Sanofi Genzyme. Dr. Wickel has nothing to disclose. Christian Geis has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alexion, Roche. Christian Geis has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion, Roche, Sobi. Dr. Hümmert has nothing to disclose. Corinna Trebst has nothing to disclose. Makbule Senel has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion, Bayer, Biogen, Merck, Roche, and Sanofi Genzyme. Dr. Klotz has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bayer. Dr. Klotz has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. Dr. Klotz has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Genzyme. Dr. Klotz has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Bristol Myers Squibb. Dr. Klotz has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Merck Serono. Dr. Klotz has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. Dr. Klotz has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Teva. Dr. Klotz has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Klotz has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Klotz has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Klotz has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Klotz has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Dr. Klotz has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Dr. Klotz has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon. Dr. Klotz has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Viatris. Dr. Klotz has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for BMS. The institution of Dr. Klotz has received research support from Immunic AG. The institution of Dr. Klotz has received research support from Merck. Dr. Gold has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biogen . Dr. Gold has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis. Dr. Gold has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Roche. Dr. Gold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genzyme. Dr. Gold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bayer Vital. Dr. Gold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eisai Pharamaceuticals. Dr. Gold has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Gold has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Gold has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for SAGE Publishers. Dr. Gold has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Novartis. Dr. Gold has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Biogen. The institution of Dr. Gold has received research support from Novartis. The institution of Dr. Gold has received research support from Biogen. Dr. Kleinschnitz has nothing to disclose. Sven G. Meuth has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Merck. Sven G. Meuth has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. Sven G. Meuth has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Almirall. Sven G. Meuth has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Celgene. Sven G. Meuth has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genzyme. Sven G. Meuth has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Sven G. Meuth has received personal compensation in the range of $500-$4,999 for serving as a Consultant for TEVA. Sven G. Meuth has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Aktas has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alexion. Dr. Aktas has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Horizon. Dr. Aktas has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Alexion. Dr. Aktas has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. Dr. Aktas has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Horizon. Dr. Aktas has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Dr. Aktas has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi. The institution of Dr. Aktas has received research support from German Research Foundation. The institution of Dr. Aktas has received research support from German Ministry of Science. The institution of Dr. Aktas has received research support from Neuromyelitis optica Study Group (NEMOS). Achim Berthele has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Achim Berthele has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bayer. Achim Berthele has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Celgene. Achim Berthele has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Achim Berthele has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Achim Berthele has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Achim Berthele has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Achim Berthele has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen. Achim Berthele has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Alexion.Marius Ringelstein has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Marius Ringelstein has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion.

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