Switch to natalizumab versus fingolimod in active relapsing-remitting multiple sclerosis
| Autor: | Mark Slee, Garbor Rum, Freek Verheul, Tomas Kalincik, Marc Girard, Pierre Duquette, Murat Terzi, Eugenio Pucci, Jeannette Lechner-Scott, Roberto Bergamaschi, Tim Spelman, Daniele Spitaleri, Cavit Boz, Alessandra Lugaresi, Suzanne Hodgkinson, Guillermo Izquierdo, Pamela A. McCombe, Francios Grand'Maison, Jose Luis Sanchez-Menoyo, Vilija Jokubaitis, Tünde Csépány, Raed Alroughani, Eva Havrdova, Csilla Rozsa, Pierre Grammond, Celia Oreja-Guevara, Ricardo Fernandez-Bolanos, Raymond Hupperts, Michael Barnett, Helmut Butzkueven, Maria Trojano, Dana Horakova, Magdolna Simó |
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| Rok vydání: | 2015 |
| Předmět: |
medicine.medical_specialty
business.industry Multiple sclerosis Placebo-controlled study medicine.disease Fingolimod Natalizumab Neurology Internal medicine Fingolimod Hydrochloride Propensity score matching Severity of illness Physical therapy Medicine Neurology (clinical) Glatiramer acetate business medicine.drug |
| Zdroj: | Annals of Neurology. 77:425-435 |
| ISSN: | 0364-5134 |
| DOI: | 10.1002/ana.24339 |
| Popis: | Objective In patients suffering multiple sclerosis activity despite treatment with interferon β or glatiramer acetate, clinicians often switch therapy to either natalizumab or fingolimod. However, no studies have directly compared the outcomes of switching to either of these agents. Methods Using MSBase, a large international, observational, prospectively acquired cohort study, we identified patients with relapsing–remitting multiple sclerosis experiencing relapses or disability progression within the 6 months immediately preceding switch to either natalizumab or fingolimod. Quasi-randomization with propensity score–based matching was used to select subpopulations with comparable baseline characteristics. Relapse and disability outcomes were compared in paired, pairwise-censored analyses. Results Of the 792 included patients, 578 patients were matched (natalizumab, n = 407; fingolimod, n = 171). Mean on-study follow-up was 12 months. The annualized relapse rates decreased from 1.5 to 0.2 on natalizumab and from 1.3 to 0.4 on fingolimod, with 50% relative postswitch difference in relapse hazard (p = 0.002). A 2.8 times higher rate of sustained disability regression was observed after the switch to natalizumab in comparison to fingolimod (p |
| Databáze: | OpenAIRE |
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