Effects of Natalizumab and Fingolimod on Clinical, Cognitive, and Magnetic Resonance Imaging Measures in Multiple Sclerosis

AbstractStudies comparing the effects of natalizumab and fingolimod in relapsing –remitting multiple sclerosis (RRMS) are limited. We aimed to compare natalizumab and fingolimod effects on clinical, neuropsychological, and MRI measures in RRMS patients after 2 years of treatment. RRMS patients starting natalizumab (n = 30) or fingolimod (n = 25) underwent neurologic, neuropsychological, and brain MRI assessments at baseline, month (M) 6, M12, and M24. Volumes of lesions, brain, gray matter (GM), white matter (WM), and deep GM were measured. Fifteen healthy controls (HC) were also scanned at baseline and M24. Treatment groups were matched for baseline variables. At M24versus baseline, both drugs reduced the relapse rate (p value  <  0.001), stabilized disability, and improved cognitive function (fingolimod:p value  = 0.03; natalizumab:p value  = 0.01), without between-group differences. The natalizumab group had a higher proportion of freedom from MRI activity (67%vs 36%,p value  = 0.02) and no evidence of disease activity-3 (NEDA-3) (57%vs 28%,p value  = 0.04). At M24vs M6, brain ( − 0.35%,p value  = 0.002 [fingolimod]; − 0.42%,p value  <  0.001 [natalizumab]), GM (− 0.62%,p value  <  0.001 [fingolimod]; − 0.64%, p value <  0.001 [natalizumab]), and WM (− 0.98%,p value  <  0.001 [fingolimod]; − 0.99%,p value  <  0.001 [natalizumab]) atrophy progressed at higher rates than in HC, b...
Source: Neurotherapeutics - Category: Neurology Source Type: research