Cladribine versus fingolimod, natalizumab and interferon β for multiple sclerosis

Tomas Kalincik, Vilija Jokubaitis, Tim Spelman, Dana Horakova, Eva Havrdova, Maria Trojano, Jeannette Lechner-Scott, Alessandra Lugaresi, Alexandre Prat, Marc Girard, Pierre Duquette, Pierre Grammond, Claudio Solaro, Francois Grand’Maison, Raymond Hupperts, Julie Prevost, Patrizia Sola, Diana Ferraro, Murat Terzi, Ernest Butler & 9 others Mark Slee, Allan Kermode, Marzena Fabis-Pedrini, Pamela McCombe, Michael Barnett, Cameron Shaw, Suzanne Hodgkinson, Helmut Butzkueven, on behalf of the MSBase Study Group

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Objective: This propensity score–matched analysis from MSBase compared the effectiveness of cladribine with interferon β, fingolimod or natalizumab. Methods: We identified all patients with relapse-onset multiple sclerosis, exposure to the study therapies and ⩾1-year on-treatment follow-up from MSBase. Three pairwise propensity score–matched analyses compared treatment outcomes over 1 year. The outcomes were hazards of first relapse, disability accumulation and disability improvement events. Sensitivity analyses were completed. Results: The cohorts consisted of 37 (cladribine), 1940 (interferon), 1892 (fingolimod) and 1410 patients (natalizumab). The probability of experiencing a relapse on cladribine was lower than on interferon (p = 0.05), similar to fingolimod (p = 0.31) and higher than on natalizumab (p = 0.042). The probability of disability accumulation on cladribine was similar to interferon (p = 0.37) and fingolimod (p = 0.089) but greater than natalizumab (p = 0.021). The probability of disability improvement was higher on cladribine than interferon (p = 0.00017), fingolimod (p = 0.0025) or natalizumab (p = 0.00099). Sensitivity analyses largely confirmed the above results. Conclusion: Cladribine is an effective therapy for relapse-onset multiple sclerosis. Its effect on relapses is comparable to fingolimod and its effect on disability accrual is comparable to interferon β and fingolimod. Cladribine may potentially associate with superior recovery from disability relative to interferon, fingolimod and natalizumab.

Original languageEnglish
Pages (from-to)1617-1626
Number of pages10
JournalMultiple Sclerosis
Volume24
Issue number12
DOIs
Publication statusPublished - Oct 2018

Keywords

  • Cladribine
  • disability
  • fingolimod
  • interferon
  • natalizumab
  • relapses

Cite this

Kalincik, T., Jokubaitis, V., Spelman, T., Horakova, D., Havrdova, E., Trojano, M., ... on behalf of the MSBase Study Group (2018). Cladribine versus fingolimod, natalizumab and interferon β for multiple sclerosis. Multiple Sclerosis, 24(12), 1617-1626. https://doi.org/10.1177/1352458517728812
Kalincik, Tomas ; Jokubaitis, Vilija ; Spelman, Tim ; Horakova, Dana ; Havrdova, Eva ; Trojano, Maria ; Lechner-Scott, Jeannette ; Lugaresi, Alessandra ; Prat, Alexandre ; Girard, Marc ; Duquette, Pierre ; Grammond, Pierre ; Solaro, Claudio ; Grand’Maison, Francois ; Hupperts, Raymond ; Prevost, Julie ; Sola, Patrizia ; Ferraro, Diana ; Terzi, Murat ; Butler, Ernest ; Slee, Mark ; Kermode, Allan ; Fabis-Pedrini, Marzena ; McCombe, Pamela ; Barnett, Michael ; Shaw, Cameron ; Hodgkinson, Suzanne ; Butzkueven, Helmut ; on behalf of the MSBase Study Group. / Cladribine versus fingolimod, natalizumab and interferon β for multiple sclerosis. In: Multiple Sclerosis. 2018 ; Vol. 24, No. 12. pp. 1617-1626.
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abstract = "Objective: This propensity score–matched analysis from MSBase compared the effectiveness of cladribine with interferon β, fingolimod or natalizumab. Methods: We identified all patients with relapse-onset multiple sclerosis, exposure to the study therapies and ⩾1-year on-treatment follow-up from MSBase. Three pairwise propensity score–matched analyses compared treatment outcomes over 1 year. The outcomes were hazards of first relapse, disability accumulation and disability improvement events. Sensitivity analyses were completed. Results: The cohorts consisted of 37 (cladribine), 1940 (interferon), 1892 (fingolimod) and 1410 patients (natalizumab). The probability of experiencing a relapse on cladribine was lower than on interferon (p = 0.05), similar to fingolimod (p = 0.31) and higher than on natalizumab (p = 0.042). The probability of disability accumulation on cladribine was similar to interferon (p = 0.37) and fingolimod (p = 0.089) but greater than natalizumab (p = 0.021). The probability of disability improvement was higher on cladribine than interferon (p = 0.00017), fingolimod (p = 0.0025) or natalizumab (p = 0.00099). Sensitivity analyses largely confirmed the above results. Conclusion: Cladribine is an effective therapy for relapse-onset multiple sclerosis. Its effect on relapses is comparable to fingolimod and its effect on disability accrual is comparable to interferon β and fingolimod. Cladribine may potentially associate with superior recovery from disability relative to interferon, fingolimod and natalizumab.",
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Kalincik, T, Jokubaitis, V, Spelman, T, Horakova, D, Havrdova, E, Trojano, M, Lechner-Scott, J, Lugaresi, A, Prat, A, Girard, M, Duquette, P, Grammond, P, Solaro, C, Grand’Maison, F, Hupperts, R, Prevost, J, Sola, P, Ferraro, D, Terzi, M, Butler, E, Slee, M, Kermode, A, Fabis-Pedrini, M, McCombe, P, Barnett, M, Shaw, C, Hodgkinson, S, Butzkueven, H & on behalf of the MSBase Study Group 2018, 'Cladribine versus fingolimod, natalizumab and interferon β for multiple sclerosis', Multiple Sclerosis, vol. 24, no. 12, pp. 1617-1626. https://doi.org/10.1177/1352458517728812

Cladribine versus fingolimod, natalizumab and interferon β for multiple sclerosis. / Kalincik, Tomas; Jokubaitis, Vilija; Spelman, Tim; Horakova, Dana; Havrdova, Eva; Trojano, Maria; Lechner-Scott, Jeannette; Lugaresi, Alessandra; Prat, Alexandre; Girard, Marc; Duquette, Pierre; Grammond, Pierre; Solaro, Claudio; Grand’Maison, Francois; Hupperts, Raymond; Prevost, Julie; Sola, Patrizia; Ferraro, Diana; Terzi, Murat; Butler, Ernest; Slee, Mark; Kermode, Allan; Fabis-Pedrini, Marzena; McCombe, Pamela; Barnett, Michael; Shaw, Cameron; Hodgkinson, Suzanne; Butzkueven, Helmut; on behalf of the MSBase Study Group.

In: Multiple Sclerosis, Vol. 24, No. 12, 10.2018, p. 1617-1626.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Cladribine versus fingolimod, natalizumab and interferon β for multiple sclerosis

AU - Kalincik, Tomas

AU - Jokubaitis, Vilija

AU - Spelman, Tim

AU - Horakova, Dana

AU - Havrdova, Eva

AU - Trojano, Maria

AU - Lechner-Scott, Jeannette

AU - Lugaresi, Alessandra

AU - Prat, Alexandre

AU - Girard, Marc

AU - Duquette, Pierre

AU - Grammond, Pierre

AU - Solaro, Claudio

AU - Grand’Maison, Francois

AU - Hupperts, Raymond

AU - Prevost, Julie

AU - Sola, Patrizia

AU - Ferraro, Diana

AU - Terzi, Murat

AU - Butler, Ernest

AU - Slee, Mark

AU - Kermode, Allan

AU - Fabis-Pedrini, Marzena

AU - McCombe, Pamela

AU - Barnett, Michael

AU - Shaw, Cameron

AU - Hodgkinson, Suzanne

AU - Butzkueven, Helmut

AU - on behalf of the MSBase Study Group

PY - 2018/10

Y1 - 2018/10

N2 - Objective: This propensity score–matched analysis from MSBase compared the effectiveness of cladribine with interferon β, fingolimod or natalizumab. Methods: We identified all patients with relapse-onset multiple sclerosis, exposure to the study therapies and ⩾1-year on-treatment follow-up from MSBase. Three pairwise propensity score–matched analyses compared treatment outcomes over 1 year. The outcomes were hazards of first relapse, disability accumulation and disability improvement events. Sensitivity analyses were completed. Results: The cohorts consisted of 37 (cladribine), 1940 (interferon), 1892 (fingolimod) and 1410 patients (natalizumab). The probability of experiencing a relapse on cladribine was lower than on interferon (p = 0.05), similar to fingolimod (p = 0.31) and higher than on natalizumab (p = 0.042). The probability of disability accumulation on cladribine was similar to interferon (p = 0.37) and fingolimod (p = 0.089) but greater than natalizumab (p = 0.021). The probability of disability improvement was higher on cladribine than interferon (p = 0.00017), fingolimod (p = 0.0025) or natalizumab (p = 0.00099). Sensitivity analyses largely confirmed the above results. Conclusion: Cladribine is an effective therapy for relapse-onset multiple sclerosis. Its effect on relapses is comparable to fingolimod and its effect on disability accrual is comparable to interferon β and fingolimod. Cladribine may potentially associate with superior recovery from disability relative to interferon, fingolimod and natalizumab.

AB - Objective: This propensity score–matched analysis from MSBase compared the effectiveness of cladribine with interferon β, fingolimod or natalizumab. Methods: We identified all patients with relapse-onset multiple sclerosis, exposure to the study therapies and ⩾1-year on-treatment follow-up from MSBase. Three pairwise propensity score–matched analyses compared treatment outcomes over 1 year. The outcomes were hazards of first relapse, disability accumulation and disability improvement events. Sensitivity analyses were completed. Results: The cohorts consisted of 37 (cladribine), 1940 (interferon), 1892 (fingolimod) and 1410 patients (natalizumab). The probability of experiencing a relapse on cladribine was lower than on interferon (p = 0.05), similar to fingolimod (p = 0.31) and higher than on natalizumab (p = 0.042). The probability of disability accumulation on cladribine was similar to interferon (p = 0.37) and fingolimod (p = 0.089) but greater than natalizumab (p = 0.021). The probability of disability improvement was higher on cladribine than interferon (p = 0.00017), fingolimod (p = 0.0025) or natalizumab (p = 0.00099). Sensitivity analyses largely confirmed the above results. Conclusion: Cladribine is an effective therapy for relapse-onset multiple sclerosis. Its effect on relapses is comparable to fingolimod and its effect on disability accrual is comparable to interferon β and fingolimod. Cladribine may potentially associate with superior recovery from disability relative to interferon, fingolimod and natalizumab.

KW - Cladribine

KW - disability

KW - fingolimod

KW - interferon

KW - natalizumab

KW - relapses

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U2 - 10.1177/1352458517728812

DO - 10.1177/1352458517728812

M3 - Article

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EP - 1626

JO - Multiple Sclerosis Journal

JF - Multiple Sclerosis Journal

SN - 1352-4585

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