Comparative analysis of dimethyl fumarate and fingolimod in relapsing-remitting multiple sclerosis.

Autor: Lorscheider J; Neurologic Clinic and Policlinic, Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland., Benkert P; Clinical Trial Unit, Department of Clinical Research, University Hospital Basel, Basel, Switzerland., Lienert C; Rheinburg Klinikum, Walzenhausen, Switzerland., Hänni P; Swiss Federation for Common Tasks of Health Insurances (SVK), Solothurn, Switzerland., Derfuss T; Neurologic Clinic and Policlinic, Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland., Kuhle J; Neurologic Clinic and Policlinic, Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland., Kappos L; Neurologic Clinic and Policlinic, Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland., Yaldizli Ö; Neurologic Clinic and Policlinic, Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland. oezguer.yaldizli@usb.ch.
Jazyk: angličtina
Zdroj: Journal of neurology [J Neurol] 2021 Mar; Vol. 268 (3), pp. 941-949. Date of Electronic Publication: 2020 Sep 24.
DOI: 10.1007/s00415-020-10226-6
Abstrakt: Background: Dimethyl fumarate and fingolimod are oral disease modifying treatments (DMTs) that reduce relapse activity and slow disability worsening in relapsing-remitting multiple sclerosis (RRMS).
Objective: To compare the effectiveness of dimethyl fumarate and fingolimod in a real-world setting, where both agents are licensed as a first-line DMT for the treatment of RRMS.
Methods: We identified patients with RRMS commencing dimethyl fumarate or fingolimod in the Swiss Federation for Common Tasks of Health Insurances (SVK) Registry between August 2014 and July 2019. Propensity score-matching was applied to select subpopulations with comparable baseline characteristics. Relapses and disability outcomes were compared in paired, pairwise-censored analyses.
Results: Of the 2113 included patients, 1922 were matched (dimethyl fumarate, n = 961; fingolimod, n = 961). Relapse rates did not differ between the groups (incident rate ratio 1.0, 95%CI 0.8-1.2, p = 0.86). Moreover, no difference in the hazard of 1-year confirmed disability worsening (hazard ratio [HR] 0.9; 95%CI 0.6-1.6; p = 0.80) or disability improvement (HR 0.9; 95%CI 0.6-1.2; p = 0.40) was detected. These findings were consistent both for treatment-naïve patients and patients switching from another DMT.
Conclusion: Dimethyl fumarate and fingolimod have comparable effectiveness regarding reduction of relapses and disability worsening in RRMS.
Databáze: MEDLINE
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