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Comparing switch to ocrelizumab, cladribine or natalizumab after fingolimod treatment cessation in multiple sclerosis
C. Zhu, Z. Zhou, I. Roos, D. Merlo, T. Kalincik, S. Ozakbas, O. Skibina, J. Kuhle, S. Hodgkinson, C. Boz, R. Alroughani, J. Lechner-Scott, M. Barnett, G. Izquierdo, A. Prat, D. Horakova, E. Kubala Havrdova, R. Macdonell, F. Patti, SJ. Khoury, M....
Jazyk angličtina Země Anglie, Velká Británie
Typ dokumentu multicentrická studie, časopisecké články
NLK
ProQuest Central
od 1944-07-01 do Před 6 měsíci
Nursing & Allied Health Database (ProQuest)
od 1944-07-01 do Před 6 měsíci
Health & Medicine (ProQuest)
od 1944-07-01 do Před 6 měsíci
Psychology Database (ProQuest)
od 1944-07-01 do Před 6 měsíci
PubMed
36261289
DOI
10.1136/jnnp-2022-330104
Knihovny.cz E-zdroje
- MeSH
- fingolimod hydrochlorid terapeutické užití MeSH
- imunosupresiva škodlivé účinky MeSH
- kladribin terapeutické užití MeSH
- kohortové studie MeSH
- lidé MeSH
- natalizumab škodlivé účinky MeSH
- nenasazení léčby MeSH
- recidiva MeSH
- relabující-remitující roztroušená skleróza * farmakoterapie MeSH
- roztroušená skleróza * farmakoterapie MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
BACKGROUND: To compare the effectiveness and treatment persistence of ocrelizumab, cladribine and natalizumab in patients with relapsing-remitting multiple sclerosis switching from fingolimod. METHODS: Using data from MSBase registry, this multicentre cohort study included subjects who had used fingolimod for ≥6 months and then switched to ocrelizumab, cladribine or natalizumab within 3 months after fingolimod discontinuation. We analysed relapse and disability outcomes after balancing covariates using an inverse-probability-treatment-weighting method. Propensity scores for the three treatments were obtained using multinomial-logistic regression. Due to the smaller number of cladribine users, comparisons of disability outcomes were limited to natalizumab and ocrelizumab. RESULTS: Overall, 1045 patients switched to ocrelizumab (n=445), cladribine (n=76) or natalizumab (n=524) after fingolimod. The annualised relapse rate (ARR) for ocrelizumab was 0.07, natalizumab 0.11 and cladribine 0.25. Compared with natalizumab, the ARR ratio (95% confidence interval [CI]) was 0.67 (0.47 to 0.96) for ocrelizumab and 2.31 (1.30 to 4.10) for cladribine; the hazard ratio (95% CI) for time to first relapse was 0.57 (0.40 to 0.83) for ocrelizumab and 1.18 (0.47 to 2.93) for cladribine. Ocrelizumab users had an 89% lower discontinuation rate (95% CI, 0.07 to 0.20) than natalizumab, but also a 51% lower probability of confirmed disability improvement (95% CI, 0.32 to 0.73). There was no difference in disability accumulation. CONCLUSION: After fingolimod cessation, ocrelizumab and natalizumab were more effective in reducing relapses than cladribine. Due to the low ARRs in all three treatment groups, additional observation time is required to determine if statistical difference in ARRs results in long-term disability differences.
Austin Health Melbourne Victoria Australia
Brain and Mind Centre University of Sydney Sydney New South Wales Australia
Cliniques Universitaires Saint Luc Brussels Belgium
Department of Medical and Surgical Sciences and Advanced Technologies GF Ingrassia Catania Italy
Department of Neurology Alfred Hospital Melbourne Victoria Australia
Department of Neurology Faculty of Medicine Hacettepe University Ankara Turkey
Department of Neurology John Hunter Hospital Newcastle New South Wales Australia
Department of Neurology Royal Melbourne Hospital Melbourne Victoria Australia
Department of Neuroscience Central Clinical School Monash University Melbourne Victoria Australia
Department of Neuroscience Imaging and Clinical Sciences University G d'Annunzio Chieti Italy
Departments of Nephrology and Neurology Liverpool Hospital Sydney New South Wales Australia
Division of Neurology Amiri Hospital Sharq Kuwait
Dokuz Eylul University İzmir Turkey
Flinders University Adelaide South Australia Australia
Hôpital Notre Dame CHUM and Universite de Montreal Montreal Québec Canada
Hospital Universitario Virgen Macarena Sevilla Spain
KTU Medical Faculty Farabi Hospital Trabzon Turkey
Menzies Institute for Medical Research University of Tasmania Hobart Tasmania Australia
Multiple Sclerosis Center University of Catania Catania Italy
School of Medicine and Public Health University Newcastle Newcastle New South Wales Australia
Citace poskytuje Crossref.org
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