Background: Patients with relapsing-remitting multiple sclerosis (RRMS) who experience relapses on a first-line therapy (interferon, glatiramer acetate, dimethyl fumarate, or teriflunomide; collectively, "BRACETD") often switch to another therapy, including natalizumab or fingolimod. Here we compare the effectiveness of switching from a first-line therapy to natalizumab or fingolimod after >= 1 relapse. Methods: Data collected prospectively in the MSBase Registry, a global, longitudinal, observational registry, were extracted on February 6, 2018. Included patients were adults with RRMS with >= 1 relapse on BRACETD therapy in the year before switching to natalizumab or fingolimod. Included patients received natalizumab or fingolimod for >= 3 months after the switch.Results: Following 1:1 propensity score matching, 1000 natalizumab patients were matched to 1000 fingolimod patients. Mean (standard deviation) follow-up time was 3.02 (2.06) years after switching to natalizumab and 2.58 (1.64) years after switching to fingolimod. Natalizumab recipients had significantly lower annualized relapse rate (relative risk=0.66; 95% confidence interval [CI], 0.59-0.74), lower risk of first relapse (hazard ratio [HR]=0.69; 95% CI, 0.60-0.80), and higher confirmed disability improvement (HR=1.27; 95% CI, 1.03-1.57) than fingolimod recipients. No difference in confirmed disability worsening was observed.Conclusions: Patients with RRMS switching from BRACETD demonstrated better outcomes with natalizumab than with fingolimod.

Switching to natalizumab or fingolimod in multiple sclerosis: Comparative effectiveness and effect of pre-switch disease activity / Spelman, Tim; Horakova, Dana; Ozakbas, Serkan; Alroughani, Raed; Onofrj, Marco; Kalincik, Tomas; Prat, Alexandre; Terzi, Murat; Grammond, Pierre; Patti, Francesco; Csepany, Tunde; Boz, Cavit; Lechner-Scott, Jeannette; Granella, Franco; Grand'Maison, Francois; van der Walt, Anneke; Zhu, Chao; Butzkueven, Helmut. - In: MULTIPLE SCLEROSIS AND RELATED DISORDERS. - ISSN 2211-0348. - 70:(2023), p. 104477. [10.1016/j.msard.2022.104477]

Switching to natalizumab or fingolimod in multiple sclerosis: Comparative effectiveness and effect of pre-switch disease activity

Granella, Franco;
2023-01-01

Abstract

Background: Patients with relapsing-remitting multiple sclerosis (RRMS) who experience relapses on a first-line therapy (interferon, glatiramer acetate, dimethyl fumarate, or teriflunomide; collectively, "BRACETD") often switch to another therapy, including natalizumab or fingolimod. Here we compare the effectiveness of switching from a first-line therapy to natalizumab or fingolimod after >= 1 relapse. Methods: Data collected prospectively in the MSBase Registry, a global, longitudinal, observational registry, were extracted on February 6, 2018. Included patients were adults with RRMS with >= 1 relapse on BRACETD therapy in the year before switching to natalizumab or fingolimod. Included patients received natalizumab or fingolimod for >= 3 months after the switch.Results: Following 1:1 propensity score matching, 1000 natalizumab patients were matched to 1000 fingolimod patients. Mean (standard deviation) follow-up time was 3.02 (2.06) years after switching to natalizumab and 2.58 (1.64) years after switching to fingolimod. Natalizumab recipients had significantly lower annualized relapse rate (relative risk=0.66; 95% confidence interval [CI], 0.59-0.74), lower risk of first relapse (hazard ratio [HR]=0.69; 95% CI, 0.60-0.80), and higher confirmed disability improvement (HR=1.27; 95% CI, 1.03-1.57) than fingolimod recipients. No difference in confirmed disability worsening was observed.Conclusions: Patients with RRMS switching from BRACETD demonstrated better outcomes with natalizumab than with fingolimod.
2023
Switching to natalizumab or fingolimod in multiple sclerosis: Comparative effectiveness and effect of pre-switch disease activity / Spelman, Tim; Horakova, Dana; Ozakbas, Serkan; Alroughani, Raed; Onofrj, Marco; Kalincik, Tomas; Prat, Alexandre; Terzi, Murat; Grammond, Pierre; Patti, Francesco; Csepany, Tunde; Boz, Cavit; Lechner-Scott, Jeannette; Granella, Franco; Grand'Maison, Francois; van der Walt, Anneke; Zhu, Chao; Butzkueven, Helmut. - In: MULTIPLE SCLEROSIS AND RELATED DISORDERS. - ISSN 2211-0348. - 70:(2023), p. 104477. [10.1016/j.msard.2022.104477]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11381/2955774
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