- Title
- Switching to natalizumab or fingolimod in multiple sclerosis: Comparative effectiveness and effect of pre-switch disease activity
- Creator
- Spelman, Tim; Horakova, Dana; Csepany, Tunde; Boz, Cavit; Lechner-Scott, Jeannette; Granella, Franco; Grand'Maison, Francois; van der Walt, Anneke; Zhu, Chao; Butzkueven, Helmut; Ozakbas, Serkan; Alroughani, Raed; Onofrj, Marco; Kalincik, Tomas; Prat, Alexandre; Terzi, Murat; Grammond, Pierre; Patti, Francesco
- Relation
- Multiple Sclerosis and Related Disorders Vol. 70, Issue February 2023, no. 104477
- Publisher Link
- http://dx.doi.org/10.1016/j.msard.2022.104477
- Publisher
- Elsevier
- Resource Type
- journal article
- Date
- 2023
- Description
- 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.
- Subject
- relapsing-remitting multiple sclerosis; treatment outcome; real-world evidence; recurrence
- Identifier
- http://hdl.handle.net/1959.13/1484343
- Identifier
- uon:51306
- Identifier
- ISSN:2211-0348
- Rights
- x
- Language
- eng
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