Natalizumab Versus Fingolimod in Patients with Relapsing-Remitting Multiple Sclerosis: A Subgroup Analysis From Three International Cohorts

AbstractIntroductionNatalizumab has proved to be more effective than fingolimod in reducing disease activity in relapsing-remitting multiple sclerosis (RRMS). Whether this association is universal for all patient groups remains to be determined.ObjectiveThe aim of this study was to compare the relative effectiveness of natalizumab and fingolimod in RRMS subgroups defined by the baseline demographic and clinical characteristics of interest.MethodsPatients with RRMS who were given natalizumab or fingolimod were identified in a merged cohort from three international registries. Efficacy outcomes were compared across subgroups based on patients ’ sex, age, disease duration, Expanded Disability Status Scale (EDSS) score, and disease and magnetic resonance imaging (MRI) activity 12 months prior to treatment initiation. Study endpoints were number of relapses (analyzed with weighted negative binomial generalized linear model) and 6-month c onfirmed disability worsening and improvement events (weighted Cox proportional hazards model), recorded during study therapy. Each patient was weighted using inverse probability of treatment weighting based on propensity score.ResultsA total of 5148 patients (natalizumab 1989; fingolimod 3159) were included, with a mean ± standard deviation age at baseline of 38 ± 10 years, and the majority (72%) were women. The median on-treatment follow-up was 25 (quartiles 15–41) months. Natalizumab was associated with fewer rela...
Source: CNS Drugs - Category: Neurology Source Type: research

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DISCUSSION: The correlation between T1 hypointense lesions' mean volume and EDSS was interpreted as low to slightly moderate. The certainty of the evidence was judged to be high.PMID:34605190 | DOI:10.1111/cns.13734
Source: CNS Neuroscience and Therapeutics - Category: Neuroscience Authors: Source Type: research
Conclusion: A deep learning model that improves the image quality of the accelerated routine clinical brain MR scans has the potential to inform clinically relevant outcomes in MS.
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Objectives: The aim of this study was to characterize multiple sclerosis (MS) patients exposed to dimethyl fumarate (DMF) and to evaluate the predictors of therapeutic response. In addition, the study offers a picture of how DMF use has changed over the past few years in naive or switcher patients.Methods: In this observational monocentric study, we examined the prescription flow of DMF in MS patients categorized as naive or switchers (for safety/tolerability, ineffectiveness, and de-escalation strategy) from 2015 to 2019. Clinical and magnetic resonance imaging data of DMF-treated patients were analyzed, and NEDA-3 status...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
ConclusionsThis analysis shows a relationship between ponesimod exposure and the cumulative number of new T1 Gd+ lesions. Sex, age, T1 Gd+ lesions at baseline, and Expanded Disability Status Score at baseline were not found to be importantly associated with the magnitude of ponesimod effect, and consequently, there is no indication from these analyses that dosage adjustments based on the explored covariates are warranted.Clinical Trial Identifier: NCT01006265, registration date 1 November, 2009.
Source: Clinical Pharmacokinetics - Category: Drugs & Pharmacology Source Type: research
Conversion to secondary progressive (SP) course is the decisive factor for long-term prognosis in relapsing multiple sclerosis (MS), generally considered the clinical equivalent of progressive MS-associated neuroaxonal degeneration. Evidence is accumulating that both inflammation and neurodegeneration are present along a continuum of pathologic processes in all phases of MS. While inflammation is the prominent feature in early stages, its quality changes and relative importance to disease course decreases while neurodegenerative processes prevail with ongoing disease. Consequently, anti-inflammatory disease-modifying thera...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
ConclusionsThese findings confirm long-term beneficial effects on disability afforded by either the recommended dose of cladribine tablets over 4  years (cumulative dose, 3.5 mg/kg) or a higher cumulative dose.Trial NCT00213135 (CLARITY); NCT00641537 (CLARITY Extension).
Source: Advances in Therapy - Category: Drugs & Pharmacology Source Type: research
Neurol Neurochir Pol. 2021 Aug 6. doi: 10.5603/PJNNS.a2021.0055. Online ahead of print.ABSTRACTAIM OF THE STUDY: To compare the demographic, clinical and laboratory characteristics of patients with multiple sclerosis (MS) analysed based on the age at which they were diagnosed.CLINICAL RATIONALE FOR THE STUDY: Most cases of MS are diagnosed between the ages of 20 and 40 years, but the clinical characteristics of patients with MS over this age range have rarely been studied.MATERIAL AND METHODS: 182 patients diagnosed with MS between 2000 and 2015 were divided into four groups by age at diagnosis:
Source: Neurologia i Neurochirurgia Polska - Category: Neurology Authors: Source Type: research
Conclusions: Natalizumab therapy showed high efficacy in treating Korean patients with active MS, without unexpected safety problems.
Source: Frontiers in Neurology - Category: Neurology Source Type: research
AbstractRecombinant interferon (IFN)  β-1b was approved by the US Food and Drug Administration as the first disease-modifying therapy (DMT) for multiple sclerosis (MS) in 1993. Since that time, clinical trials and real-world observational studies have demonstrated the effectiveness of IFN therapies. The pivotal intramuscular IFN β- 1a phase III trial published in 1996 was the first to demonstrate that a DMT could reduce accumulation of sustained disability in MS. Patient adherence to treatment is higher with intramuscular IFN β-1a, given once weekly, than with subcutaneous formulations requiri...
Source: CNS Drugs - Category: Neurology Source Type: research
This study included 53 RRMS remission patients, 30 RRMS relapse/post-relapse patients and 44 healthy volunteers. Blood samples were collected once from RRMS patients in remission and from the control group, and twice from RRMS relapse patients: once when relapsing and another 1 month after relapse. The endocan, CRP and NLR levels of the RRMS patients measured while in relapse, 1 month after relapse and while in remission were compared to those of the control group. The studied parameters were compared with the disease duration, relapse frequency, Expanded Disability Status Scale (EDSS) score, applied treatment and lesion b...
Source: European Review for Medical and Pharmacological Sciences - Category: Drugs & Pharmacology Authors: Source Type: research
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