Comparison of switch to fingolimod or interferon beta/glatiramer acetate in active multiple sclerosi

Anna He, Tim Spelman, Vilija G Jokubaitis, Eva Havrdova, Dana Horakova, Maria Trojano, Alessandra Lugaresi, Guillermo Izquierdo, Pierre Grammond, Pierre Duquette, Marc Girard, Eugenio Pucci, Gerardo Iuliano, Raed A Alroughani, Celia Oreja-Guevara, Ricardo Fernandez-Bolanos, Francois Grand'Maison, Patrizia Sola, Daniele La Spitaleri, Franco GranellaMurat Terzi, Jeannette Lechner-Scott, Vincent Van Pesch, Raymond Hupperts, Jose Sanchez-Menoyo, Suzanne J Hodgkinson, Csilla Rozsa, Freek Verheul, Helmut Butzkueven, Tomas Kalincik, for the MSBase Study Group

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IMPORTANCE After multiple sclerosis (MS) relapse while a patient is receiving an injectable disease-modifying drug, many physicians advocate therapy switch, but the relative effectiveness of different switch decisions is often uncertain.OBJECTIVE To compare the effect of the oral immunomodulator fingolimod with that of all injectable immunomodulators (interferons or glatiramer acetate) on relapse rate, disability, and treatment persistence in patients with activeMS. DESIGN, SETTING, AND PARTICIPANTS Matched retrospective analysis of data collected prospectively from MSBase, an international, observational cohort study. The MSBase cohort represents a population of patients with MS monitored at large MS centers. The analyzed data were collected between July 1996 and April 2014. Participants included patients with relapsing-remittingMS who were switching therapy to fingolimod or injectable immunomodulators up to 12 months after on-treatment clinical disease activity (relapse or progression of disability), matched on demographic and clinical variables. Median follow-up duration was 13.1 months (range, 3-80). Indication and attrition bias were controlled with propensity score matching and pairwise censoring, respectively. Head-to-head analyses of relapse and disability outcomes used paired, weighted, negative binomial models or frailty proportional hazards models adjusted formagnetic resonance imaging variables. Sensitivity analyses were conducted. EXPOSURES Patients had received fingolimod, interferon beta, or glatiramer acetate for a minimum of 3 months following a switch of immunomodulatory therapy.
Original languageEnglish
Pages (from-to)405 - 413
Number of pages9
JournalJAMA Neurology
Issue number4
Publication statusPublished - 2015

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He, A., Spelman, T., Jokubaitis, V. G., Havrdova, E., Horakova, D., Trojano, M., Lugaresi, A., Izquierdo, G., Grammond, P., Duquette, P., Girard, M., Pucci, E., Iuliano, G., Alroughani, R. A., Oreja-Guevara, C., Fernandez-Bolanos, R., Grand'Maison, F., Sola, P., Spitaleri, D. L., ... for the MSBase Study Group (2015). Comparison of switch to fingolimod or interferon beta/glatiramer acetate in active multiple sclerosi. JAMA Neurology, 72(4), 405 - 413.