Risk of early relapse following the switch from injectables to oral agents for multiple sclerosis
Language English Country England, Great Britain Media print-electronic
Document type Journal Article
PubMed
26782663
DOI
10.1111/ene.12929
Knihovny.cz E-resources
- Keywords
- dimethyl fumarate, fingolimod, multiple sclerosis, progression, relapse, teriflunomide, treatment switching,
- MeSH
- Administration, Oral MeSH
- Adult MeSH
- Glatiramer Acetate administration & dosage pharmacology MeSH
- Outcome Assessment, Health Care * MeSH
- Immunologic Factors administration & dosage pharmacology MeSH
- Interferon-beta administration & dosage pharmacology MeSH
- Middle Aged MeSH
- Humans MeSH
- Longitudinal Studies MeSH
- Disease Progression * MeSH
- Recurrence MeSH
- Registries * MeSH
- Multiple Sclerosis, Relapsing-Remitting drug therapy MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Names of Substances
- Glatiramer Acetate MeSH
- Immunologic Factors MeSH
- Interferon-beta MeSH
BACKGROUND AND PURPOSE: Early relapse outcomes in long-term stable patients switching from interferon β/glatiramer acetate (IFNβ/GA) to oral therapy are unknown. OBJECTIVE: The objective of this study was to compare early relapse and progression in multiple sclerosis (MS) patients switching to oral therapy following a period of stable disease on IFNβ/GA, relative to a propensity-matched comparator of patients remaining on IFNβ/GA. METHODS: The MSBase cohort study is a global, longitudinal registry for MS. Time to first 6-month relapse in previously stable MS patients switching from platform injectables ('switchers') to oral agents were compared with propensity-matched patients remaining on IFNβ/GA ('stayers') using a Cox marginal model. RESULTS: Three-hundred and ninety-six switchers were successfully matched to 396 stayers on a 1:1 basis. There was no difference in the proportion of patients recording at least one relapse in the first 1-6 months by treatment arm (7.3% switchers, 6.6% stayers; P = 0.675). The mean annualized relapse rate (P = 0.493) and the rate of first 6-month relapse by treatment arm (hazard ratio 1.22, 95% confidence interval 0.70, 2.11) were also comparable. There was no difference in the rate of disability progression by treatment arm (hazard ratio 1.43, 95% confidence interval 0.63, 3.26). CONCLUSION: This is the first study to compare early relapse switch probability in the period immediately following switch to oral treatment in a population previously stable on injectable therapy. There was no evidence of disease reactivation within the first 6 months of switching to oral therapy.
Amiri Hospital Kuwait City Kuwait
Brain and Mind Research Institute Sydney NSW Australia
Center de réadaptation déficience physique Chaudière Appalache Levis QC Canada
Charles University Prague Czech Republic
Department of Basic Medical Sciences Neuroscience and Sense Organs University of Bari Bari Italy
Department of Medicine University of Melbourne Parkville Vic Australia
Department of Neurology Royal Melbourne Hospital Parkville Vic Australia
Department of Neurosciences University of Parma Parma Italy
Hôpital Notre Dame Montreal QC Canada
Hospital Universitario Virgen Macarena Sevilla Spain
John Hunter Hospital Newcastle NSW Australia
Liverpool Hospital Sydney NSW Australia
Neuro Rive Sud Hôpital Charles LeMoyne Quebec QC Canada
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