| Autor: |
Zecca, Chiara, Merlini, Arianna, Disanto, Giulio, Rodegher, Mariaemma, Panicari, Letizia, Romeo, Marzia Anita Lucia, Candrian, Ursula, Messina, Maria Josè, Pravatà, Emanuele, Moiola, Lucia, Stefanin, Catia, Ghezzi, Angelo, Perrone, Patrizia, Patti, Francesco, Comi, Giancarlo, Gobbi, Claudio, Martinelli, Vittorio |
| Předmět: |
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| Zdroj: |
Multiple Sclerosis Journal; Feb2018, Vol. 24 Issue 2, p167-174, 8p, 3 Charts, 2 Graphs |
| Abstrakt: |
Objectives: To investigate the efficacy and safety of fingolimod (FTY) 0.5 mg administered every other day (FTY-EOD) compared to every day (FTY-ED) in multiple sclerosis patients. Methods: Multicentre retrospective observational study. Clinical, laboratory and neuroimaging data were consecutively collected from 60 FTY-EOD and 63 FTY-ED patients. Baseline characteristics were compared using logistic regression. Efficacy in preventing occurrence of relapses and demyelinating lesions was tested using propensity score--adjusted Cox and linear regressions. Results: Weight was inversely associated with risk of switch to FTY-EOD because of any reason (odds ratio (OR) = 0.94, 95% confidence interval (95% CI) = 0.89-0.99, p = 0.026), and female sex and lower baseline lymphocyte count were positively associated with switch because of lymphopenia. Compared to FTY-ED patients, FTY-EOD patients were at higher risk of developing relapses (hazard ratio (HR) = 2.98, 95% CI = 1.07-8.27, p = 0.036) and either relapses or new magnetic resonance imaging (MRI) demyelinating lesions (combined outcome, HR = 2.07, 95% CI = 1.06-4.08, p = 0.034). Within FTY-EOD, treatment with natalizumab before FTY and lower age were positively associated with risk of developing relapses and combined outcome, respectively (HR = 25.71, 95% CI = 3.03-217.57, p = 0.002 and HR = 0.85, 95% CI = 0.77-0.96, p = 0.005). FTY-EOD was overall well tolerated. Conclusion: Disease reactivation was observed in a significant proportion of patients treated with FTYEOD. Neurologists should be cautious when reducing FTY administration to every other day, especially in younger patients and those previously treated with natalizumab. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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