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Oral therapies for treatment of relapsing-remitting multiple sclerosis in Austria: a 2-year comparison using an inverse probability weighting method.
J Neurol. 2020 Jul; 267(7):2090-2100.JN

Abstract

OBJECTIVES

To compare the efficacies, frequencies and reasons for treatment interruption of fingolimod (FTY), dimethyl fumarate (DMF) or teriflunomide (TERI) in a nationwide observational cohort.

MATERIALS AND METHODS

Two cohorts of patients with relapsing-remitting multiple sclerosis (RRMS) having started treatment with FTY, DMF or TERI documented in the Austrian MS Treatment Registry (AMSTR) since 2014 and either staying on therapy for at least 24 months (24 m cohort) or with at least one follow-up visit after start of treatment (total cohort). The 24 m cohort included 629 RRMS patients: 295 in the FTY, 227 in the DMF and 107 in the TERI group. We used multinomial propensity scores for inverse probability weighting in generalized linear and Cox proportional hazards models to correct for the bias of this non-randomised registry study.

RESULTS

Estimated mean annualized relapse rates (ARR) over 24 months were 0.13 for FTY, 0.09 for DMF and 0.11 for TERI treatment. For TERI in comparison with DMF, we observed higher probability for treatment interruption (p = 0.023) and reduced sustained EDSS regression for 12 (p = 0.016) and 24 weeks (p = 0.031) and, for the comparison of DMF versus FTY, a reduced sustained EDSS progression for 12 weeks (p = 0.02).

CONCLUSIONS

Relapse rates with treatment with FTY, DMF and TERI were similar. Patients treated with DMF showed less sustained disability progression for 12 weeks than FTY-treated patients. However, FTY and DMF treatment was associated with more likely EDSS regression for 12 and 24 weeks and a lower probability for treatment interruption as compared to TERI-treated patients.

Authors+Show Affiliations

Clinic for Neurology 2, Kepler University Hospital GmbH, Med Campus III, Krankenhausstr. 9, 4021, Linz, Austria. Michael.Guger@kepleruniklinikum.at. Medical Faculty, Johannes Kepler University Linz, Linz, Austria. Michael.Guger@kepleruniklinikum.at.Department of Neurology, Medical University of Graz, Graz, Austria.Department of Neurology, Medical University of Vienna, Vienna, Austria.Department of Laboratory Medicine, Paracelsus Medical University and Salzburger Landeskliniken, Salzburg, Austria. Department of Neurology, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany.Hermesoft, Data management, Graz, Austria.Hermesoft, Statistics, Graz, Austria.Department of Neurology, Medical University of Vienna, Vienna, Austria.No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32246251

Citation

Guger, Michael, et al. "Oral Therapies for Treatment of Relapsing-remitting Multiple Sclerosis in Austria: a 2-year Comparison Using an Inverse Probability Weighting Method." Journal of Neurology, vol. 267, no. 7, 2020, pp. 2090-2100.
Guger M, Enzinger C, Leutmezer F, et al. Oral therapies for treatment of relapsing-remitting multiple sclerosis in Austria: a 2-year comparison using an inverse probability weighting method. J Neurol. 2020;267(7):2090-2100.
Guger, M., Enzinger, C., Leutmezer, F., Kraus, J., Kalcher, S., Kvas, E., & Berger, T. (2020). Oral therapies for treatment of relapsing-remitting multiple sclerosis in Austria: a 2-year comparison using an inverse probability weighting method. Journal of Neurology, 267(7), 2090-2100. https://doi.org/10.1007/s00415-020-09811-6
Guger M, et al. Oral Therapies for Treatment of Relapsing-remitting Multiple Sclerosis in Austria: a 2-year Comparison Using an Inverse Probability Weighting Method. J Neurol. 2020;267(7):2090-2100. PubMed PMID: 32246251.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Oral therapies for treatment of relapsing-remitting multiple sclerosis in Austria: a 2-year comparison using an inverse probability weighting method. AU - Guger,Michael, AU - Enzinger,Christian, AU - Leutmezer,Fritz, AU - Kraus,Jörg, AU - Kalcher,Stefan, AU - Kvas,Erich, AU - Berger,Thomas, AU - ,, Y1 - 2020/04/03/ PY - 2020/01/13/received PY - 2020/03/25/accepted PY - 2020/03/25/revised PY - 2020/4/5/pubmed PY - 2020/4/5/medline PY - 2020/4/5/entrez KW - Comparison KW - Dimethyl fumarate KW - Fingolimod KW - Inverse probability weighting KW - Multiple sclerosis KW - Teriflunomide SP - 2090 EP - 2100 JF - Journal of neurology JO - J. Neurol. VL - 267 IS - 7 N2 - OBJECTIVES: To compare the efficacies, frequencies and reasons for treatment interruption of fingolimod (FTY), dimethyl fumarate (DMF) or teriflunomide (TERI) in a nationwide observational cohort. MATERIALS AND METHODS: Two cohorts of patients with relapsing-remitting multiple sclerosis (RRMS) having started treatment with FTY, DMF or TERI documented in the Austrian MS Treatment Registry (AMSTR) since 2014 and either staying on therapy for at least 24 months (24 m cohort) or with at least one follow-up visit after start of treatment (total cohort). The 24 m cohort included 629 RRMS patients: 295 in the FTY, 227 in the DMF and 107 in the TERI group. We used multinomial propensity scores for inverse probability weighting in generalized linear and Cox proportional hazards models to correct for the bias of this non-randomised registry study. RESULTS: Estimated mean annualized relapse rates (ARR) over 24 months were 0.13 for FTY, 0.09 for DMF and 0.11 for TERI treatment. For TERI in comparison with DMF, we observed higher probability for treatment interruption (p = 0.023) and reduced sustained EDSS regression for 12 (p = 0.016) and 24 weeks (p = 0.031) and, for the comparison of DMF versus FTY, a reduced sustained EDSS progression for 12 weeks (p = 0.02). CONCLUSIONS: Relapse rates with treatment with FTY, DMF and TERI were similar. Patients treated with DMF showed less sustained disability progression for 12 weeks than FTY-treated patients. However, FTY and DMF treatment was associated with more likely EDSS regression for 12 and 24 weeks and a lower probability for treatment interruption as compared to TERI-treated patients. SN - 1432-1459 UR - https://www.unboundmedicine.com/medline/citation/32246251/Oral_therapies_for_treatment_of_relapsing-remitting_multiple_sclerosis_in_Austria:_a_2-year_comparison_using_an_inverse_probability_weighting_method L2 - https://dx.doi.org/10.1007/s00415-020-09811-6 DB - PRIME DP - Unbound Medicine ER -
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