Tags

Type your tag names separated by a space and hit enter

Natalizumab versus fingolimod in patients with relapsing-remitting multiple sclerosis non-responding to first-line injectable therapies.
Mult Scler. 2016 09; 22(10):1315-26.MS

Abstract

BACKGROUND

Natalizumab and fingolimod have not been compared in controlled trials but only in observational studies, with inconclusive results.

OBJECTIVES

The objective of this study is to compare the effect of natalizumab and fingolimod in reducing disease activity in relapsing-remitting multiple sclerosis (RRMS).

METHODS

We included all consecutive RRMS patients switched from first-line agents (glatiramer acetate/interferons) to natalizumab or fingolimod, with a follow-up of 24 months. Data of relapses, Expanded Disability Status Scale score and brain magnetic resonance imaging (MRI) scans were collected. We used propensity score (PS) matching and intention-to-treat analysis.

RESULTS

We retained 102 patients in each cohort after PS matching, with similar baseline characteristics. More patients discontinued natalizumab compared to fingolimod (33% vs 11%, p < 0.001), mainly for progressive multifocal leukoencephalopathy (PML) concern. No serious adverse events occurred in the two cohorts. Compared to fingolimod, the natalizumab group presented a higher percentage of relapse-free patients (66% vs 80%, p = 0.015), a higher percentage of disability-improved patients (6% vs 15%, p = 0.033), a lower percentage of MRI-active patients (38% vs 14%, p = 0.001) and a higher percentage of patients with no evidence of disease activity (NEDA-3; 44% vs 70%, p < 0.001) after 2 years of follow-up. Disability worsening was not statistically different in the two groups.

CONCLUSION

Natalizumab is superior to fingolimod in RRMS patients non-responding to first-line agents.

Authors+Show Affiliations

Multiple Sclerosis Study Center, Sant'Antonio Abate Hospital, Gallarate, Italy damianobaroncini@gmail.com.Multiple Sclerosis Study Center, Sant'Antonio Abate Hospital, Gallarate, Italy.Multiple Sclerosis Study Center, Sant'Antonio Abate Hospital, Gallarate, Italy.Department of Neurology, San Raffaele Hospital, Milan, Italy.Department of Neurology, San Raffaele Hospital, Milan, Italy.Department of Neuroradiology, Sant'Antonio Abate Hospital, Gallarate, Italy.Department of Neurology, San Raffaele Hospital, Milan, Italy.Department of Neurology, San Raffaele Hospital, Milan, Italy.Multiple Sclerosis Study Center, Sant'Antonio Abate Hospital, Gallarate, Italy.Department of Neurology, San Raffaele Hospital, Milan, Italy/Division of Neuroscience, Department of Neurology, Institute of Experimental Neurology, San Raffaele Scientific Institute, Milan, Italy.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

27230789

Citation

Baroncini, Damiano, et al. "Natalizumab Versus Fingolimod in Patients With Relapsing-remitting Multiple Sclerosis Non-responding to First-line Injectable Therapies." Multiple Sclerosis (Houndmills, Basingstoke, England), vol. 22, no. 10, 2016, pp. 1315-26.
Baroncini D, Ghezzi A, Annovazzi PO, et al. Natalizumab versus fingolimod in patients with relapsing-remitting multiple sclerosis non-responding to first-line injectable therapies. Mult Scler. 2016;22(10):1315-26.
Baroncini, D., Ghezzi, A., Annovazzi, P. O., Colombo, B., Martinelli, V., Minonzio, G., Moiola, L., Rodegher, M., Zaffaroni, M., & Comi, G. (2016). Natalizumab versus fingolimod in patients with relapsing-remitting multiple sclerosis non-responding to first-line injectable therapies. Multiple Sclerosis (Houndmills, Basingstoke, England), 22(10), 1315-26. https://doi.org/10.1177/1352458516650736
Baroncini D, et al. Natalizumab Versus Fingolimod in Patients With Relapsing-remitting Multiple Sclerosis Non-responding to First-line Injectable Therapies. Mult Scler. 2016;22(10):1315-26. PubMed PMID: 27230789.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Natalizumab versus fingolimod in patients with relapsing-remitting multiple sclerosis non-responding to first-line injectable therapies. AU - Baroncini,Damiano, AU - Ghezzi,Angelo, AU - Annovazzi,Pietro O, AU - Colombo,Bruno, AU - Martinelli,Vittorio, AU - Minonzio,Giorgio, AU - Moiola,Lucia, AU - Rodegher,Mariaemma, AU - Zaffaroni,Mauro, AU - Comi,Giancarlo, Y1 - 2016/05/26/ PY - 2015/12/18/received PY - 2016/04/26/accepted PY - 2016/5/28/entrez PY - 2016/5/28/pubmed PY - 2018/1/18/medline KW - Multiple sclerosis KW - comparison KW - fingolimod KW - natalizumab KW - second line SP - 1315 EP - 26 JF - Multiple sclerosis (Houndmills, Basingstoke, England) JO - Mult. Scler. VL - 22 IS - 10 N2 - BACKGROUND: Natalizumab and fingolimod have not been compared in controlled trials but only in observational studies, with inconclusive results. OBJECTIVES: The objective of this study is to compare the effect of natalizumab and fingolimod in reducing disease activity in relapsing-remitting multiple sclerosis (RRMS). METHODS: We included all consecutive RRMS patients switched from first-line agents (glatiramer acetate/interferons) to natalizumab or fingolimod, with a follow-up of 24 months. Data of relapses, Expanded Disability Status Scale score and brain magnetic resonance imaging (MRI) scans were collected. We used propensity score (PS) matching and intention-to-treat analysis. RESULTS: We retained 102 patients in each cohort after PS matching, with similar baseline characteristics. More patients discontinued natalizumab compared to fingolimod (33% vs 11%, p < 0.001), mainly for progressive multifocal leukoencephalopathy (PML) concern. No serious adverse events occurred in the two cohorts. Compared to fingolimod, the natalizumab group presented a higher percentage of relapse-free patients (66% vs 80%, p = 0.015), a higher percentage of disability-improved patients (6% vs 15%, p = 0.033), a lower percentage of MRI-active patients (38% vs 14%, p = 0.001) and a higher percentage of patients with no evidence of disease activity (NEDA-3; 44% vs 70%, p < 0.001) after 2 years of follow-up. Disability worsening was not statistically different in the two groups. CONCLUSION: Natalizumab is superior to fingolimod in RRMS patients non-responding to first-line agents. SN - 1477-0970 UR - https://www.unboundmedicine.com/medline/citation/27230789/Natalizumab_versus_fingolimod_in_patients_with_relapsing_remitting_multiple_sclerosis_non_responding_to_first_line_injectable_therapies_ L2 - http://journals.sagepub.com/doi/full/10.1177/1352458516650736?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -