Author Topic: (Abst.) Comparison of MS clinical disease activity in patients on Tysabri and fingolimod  (Read 74 times)

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Offline agate

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From Multiple Sclerosis Journal, April 7, 2016:

Quote
A comparison of multiple sclerosis clinical disease activity between patients treated with natalizumab and fingolimod

Nils Koch-Henriksen⇑
Department of Clinical Epidemiology, Clinical Institute, Aarhus University, Aarhus, Denmark/The Danish Multiple Sclerosis Registry, Neuroscience Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

Melinda Magyari
The Danish Multiple Sclerosis Registry, Neuroscience Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark/The Danish Multiple Sclerosis Center, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark

Finn Sellebjerg
The Danish Multiple Sclerosis Center, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark

Per Soelberg Sørensen
The Danish Multiple Sclerosis Center, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark

The Danish Multiple Sclerosis Registry, Neuroscience Centre, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark. koch-henriksen@stofanet.dk

Background:


Natalizumab and fingolimod were approved for treatment of active relapsing-remitting multiple sclerosis (RRMS) in Denmark in 2006 and 2011, respectively. There have been no randomized head-to-head studies comparing the two drugs.

Objective:

To compare the clinical efficacy of natalizumab and fingolimod.

Methods:


Data on all Danish RRMS patients who started their first second-line treatment with natalizumab or fingolimod from July 2011 to March 2015 were prospectively recorded in the Danish Multiple Sclerosis (MS) Treatment Register.

The two treatment arms were 1:1 propensity score matched by baseline covariates using ‘nearest neighbour’ method.

Results:

Propensity score matching left 928 of 1309 RRMS cases, 464 in each treatment group. The on-treatment annualized relapse rate was 0.296 (95% confidence interval (CI): 0.26–0.34) for natalizumab and 0.307 (95% CI: 0.27–0.35) for fingolimod.

The adjusted relapse rate ratio was 0.93 (95% CI: 0.74–1.17; p = 0.53). Mean time to first relapse was 2.55 and 2.56 years, respectively (p = 0.76). There was no difference in change of Expanded Disability Status Scale (EDSS).

Conclusion:

We found no differences in clinical disease activity between natalizumab- and fingolimod-treated RRMS patients in this real-life observational study. However, the lack of magnetic resonance imaging (MRI) data for the propensity score matching may conceal a higher efficacy of natalizumab.
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