TY - JOUR
T1 - Comparative effectiveness of dimethyl fumarate versus non-specific immunosuppressants
T2 - Real-world evidence from MSBase
AU - Spelman, Tim
AU - Eichau, Sara
AU - Alroughani, Raed
AU - Ozakbas, Serkan
AU - Khoury, Samia J.
AU - Patti, Francesco
AU - Kubala Havrdova, Eva
AU - Boz, Cavit
AU - Terzi, Murat
AU - Kuhle, Jens
AU - Grammond, Pierre
AU - Lechner-Scott, Jeanette
AU - Gray, Orla
AU - Amato, Maria Pia
AU - Laureys, Guy
AU - Shaygannejad, Vahid
AU - Hyde, Robert
AU - Wang, Haijue
AU - Bozin, Ivan
AU - Belviso, Nicholas
AU - Quan, Chao
AU - Zeng, Feng
AU - van der Walt, Anneke
AU - Butzkueven, Helmut
AU - the MSBase Study Group
N1 - Publisher Copyright:
© The Author(s), 2024.
PY - 2024/4
Y1 - 2024/4
N2 - Background: The use of non-specific immunosuppressants (NSIS) to treat multiple sclerosis (MS) remains prevalent in certain geographies despite safety concerns, likely due to resource limitations. Objective: To use MSBase registry data to compare real-world outcomes in adults with relapsing-remitting MS (RRMS) treated with dimethyl fumarate (DMF) or NSIS (azathioprine, cyclosporine, cyclophosphamide, methotrexate, mitoxantrone or mycophenolate mofetil) between January 1, 2014 and April 1, 2022. Methods: Treatment outcomes were compared using inverse probability of treatment weighting (IPTW) Cox regression. Outcomes were annualized relapse rates (ARRs), time to discontinuation, time to first relapse (TTFR) and time to 24-week confirmed disability progression (CDP) or 24-week confirmed disability improvement (CDI; in patients with baseline Expanded Disability Status Scale [EDSS] score ≥2). Results: After IPTW, ARR was similar for DMF (0.13) and NSIS (0.16; p = 0.29). There was no difference in TTFR between cohorts (hazard ratio [HR]: 0.98; p = 0.84). The DMF cohort experienced longer times to discontinuation (HR: 0.75; p = 0.001) and CDP (HR: 0.53; p = 0.001), and shorter time to CDI (HR: 1.99; p < 0.008), versus the NSIS cohort. Conclusion: This analysis supports the use of DMF to treat patients with relapsing forms of MS, and may have implications for MS practices in countries where NSIS are commonly used to treat RRMS.
AB - Background: The use of non-specific immunosuppressants (NSIS) to treat multiple sclerosis (MS) remains prevalent in certain geographies despite safety concerns, likely due to resource limitations. Objective: To use MSBase registry data to compare real-world outcomes in adults with relapsing-remitting MS (RRMS) treated with dimethyl fumarate (DMF) or NSIS (azathioprine, cyclosporine, cyclophosphamide, methotrexate, mitoxantrone or mycophenolate mofetil) between January 1, 2014 and April 1, 2022. Methods: Treatment outcomes were compared using inverse probability of treatment weighting (IPTW) Cox regression. Outcomes were annualized relapse rates (ARRs), time to discontinuation, time to first relapse (TTFR) and time to 24-week confirmed disability progression (CDP) or 24-week confirmed disability improvement (CDI; in patients with baseline Expanded Disability Status Scale [EDSS] score ≥2). Results: After IPTW, ARR was similar for DMF (0.13) and NSIS (0.16; p = 0.29). There was no difference in TTFR between cohorts (hazard ratio [HR]: 0.98; p = 0.84). The DMF cohort experienced longer times to discontinuation (HR: 0.75; p = 0.001) and CDP (HR: 0.53; p = 0.001), and shorter time to CDI (HR: 1.99; p < 0.008), versus the NSIS cohort. Conclusion: This analysis supports the use of DMF to treat patients with relapsing forms of MS, and may have implications for MS practices in countries where NSIS are commonly used to treat RRMS.
KW - Dimethyl fumarate
KW - effectiveness
KW - non-specific immunosuppressants
KW - real-world
KW - relapsing-remitting multiple sclerosis
UR - http://www.scopus.com/inward/record.url?scp=85194855409&partnerID=8YFLogxK
U2 - 10.1177/20552173241247182
DO - 10.1177/20552173241247182
M3 - Article
C2 - 38800132
AN - SCOPUS:85194855409
SN - 2055-2173
VL - 10
SP - 1
EP - 13
JO - Multiple Sclerosis Journal - Experimental, Translational and Clinical
JF - Multiple Sclerosis Journal - Experimental, Translational and Clinical
IS - 2
ER -