Background: The introduction of oral disease-modifying therapies (DMTs) for relapsing–remitting multiple sclerosis (RRMS) changed algorithms of RRMS treatment. Objectives: To compare the effectiveness of treatment with dimethyl fumarate (DMF) and teriflunomide (TRF) in a large multicentre Italian cohort of RRMS patients. Materials and Methods: Patients with RRMS who received treatment with DMF and TRF between January 1st, 2012 and December 31st, 2018 from twelve MS centers were identified. The events investigated were “time-to-first-relapse”, “time-to-Magnetic-Resonance-Imaging (MRI)-activity” and “time-to-disability-progression”. Results: 1445 patients were enrolled (1039 on DMF, 406 on TRF) and followed for a median of 34 months. Patients on TRF were older (43.5 ± 8.6 vs 38.8 ± 9.2 years), with a predominance of men and higher level of disability (p < 0.001 for all). Patients on DMF had a higher number of relapses and radiological activity (p <.05) at baseline. Time-varying Cox-model for the event “time-to-first relapse” revealed that no differences were found between the two groups in the first 38 months of treatment (HRt < 38DMF = 0.73, CI = 0.52 to 1.03, p = 0.079). When the time-on-therapy exceeds 38 months patients on DMF had an approximately 0.3 times lower relapse hazard risk than those who took TRF (HRt>38DMF = 3.83, CI = 1.11 to 13.23, p = 0.033). Both DMTs controlled similarly MRI activity and disability progression. Conclusions: Patients on DMF had higher relapse-free survival time than TRF group after the first 38 months ontherapy.
Dimethyl fumarate vs Teriflunomide: an Italian time-to-event data analysis / D'Amico, E.; Zanghi, A.; Sciandra, M.; Lanzillo, R.; Callari, G.; Cortese, A.; Lus, G.; Lucchini, M.; Buccafusca, M.; Bonavita, S.; Gallo, A.; Curti, E.; Gajofatto, A.; Signoriello, E.; Bisecco, A.; Gobbin, F.; Ferro, M. T.; Ferrazzano, G.; Sparaco, M.; Valentino, P.; Mirabella, M.; Granella, F.; Bresciamorra, V.; Grimaldi, L. M. E.; Patti, F.; Borriello, G.; Grossi, P.; Carotenuto, A.; Siena, E.; Tsantes, E.; Giugno, A.; Abbadessa, G. M.; Chisari, C. G.. - In: JOURNAL OF NEUROLOGY. - ISSN 0340-5354. - (2020), pp. 1-13. [10.1007/s00415-020-09959-1]
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