Comparative effectiveness of teriflunomide vs dimethyl fumarate in multiple sclerosis.
Adult
Crotonates
/ therapeutic use
Dimethyl Fumarate
/ therapeutic use
Disease Progression
Female
Fingolimod Hydrochloride
/ therapeutic use
Humans
Hydroxybutyrates
Immunosuppressive Agents
/ therapeutic use
Male
Middle Aged
Multiple Sclerosis
/ drug therapy
Nitriles
Recurrence
Toluidines
/ therapeutic use
Treatment Outcome
Journal
Neurology
ISSN: 1526-632X
Titre abrégé: Neurology
Pays: United States
ID NLM: 0401060
Informations de publication
Date de publication:
13 08 2019
13 08 2019
Historique:
received:
10
11
2018
accepted:
10
04
2019
pubmed:
14
7
2019
medline:
29
1
2020
entrez:
14
7
2019
Statut:
ppublish
Résumé
In this study, we compared the effectiveness of teriflunomide (TRF) and dimethyl fumarate (DMF) on both clinical and MRI outcomes in patients followed prospectively in the Observatoire Français de la Sclérose en Plaques. A total of 1,770 patients with relapsing-remitting multiple sclerosis (RRMS) (713 on TRF and 1,057 on DMF) with an available baseline brain MRI were included in intention to treat. The 1- and 2-year postinitiation outcomes were relapses, increase of T2 lesions, increase in Expanded Disability Status Scale score, and reason for treatment discontinuation. Propensity scores (inverse probability weighting) and logistic regressions were estimated. The confounder-adjusted proportions of patients were similar in TRF- compared to DMF-treated patients for relapses and disability progression after 1 and 2 years. However, the adjusted proportion of patients with at least one new T2 lesion after 2 years was lower in DMF compared to TRF (60.8% vs 72.2%, odds ratio [OR] 0.60, After 2 years of treatment, we found similar effectiveness of DMF and TRF in terms of clinical outcomes, but with better MRI-based outcomes for DMF-treated patients, resulting in a lower rate of treatment discontinuation due to lack of effectiveness. This study provides Class III evidence that for patients with RRMS, TRF and DMF have similar clinical effectiveness after 2 years of treatment.
Identifiants
pubmed: 31300547
pii: WNL.0000000000007938
doi: 10.1212/WNL.0000000000007938
pmc: PMC6715507
doi:
Substances chimiques
Crotonates
0
Hydroxybutyrates
0
Immunosuppressive Agents
0
Nitriles
0
Toluidines
0
teriflunomide
1C058IKG3B
Dimethyl Fumarate
FO2303MNI2
Fingolimod Hydrochloride
G926EC510T
Types de publication
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e635-e646Investigateurs
B Fontaine
(B)
R Marignier
(R)
F Durand-Dubief
(F)
G Mathey
(G)
E Le Page
(E)
D Peaureaux-Averseng
(D)
J C Ouallet
(JC)
A Ruet
(A)
N Collongues
(N)
P Hautecoeur
(P)
H Zephir
(H)
E Maillard
(E)
M Cohen
(M)
N Derache
(N)
P Branger
(P)
X Ayrignac
(X)
C Carra-Dalliere
(C)
A Fromont
(A)
L Chamard-Witkowski
(L)
F Taithe
(F)
X Moisset
(X)
B Audoin
(B)
A Rico-Lamy
(A)
G Castelnovo
(G)
C Giannesini
(C)
O Fagniez
(O)
C Bensa
(C)
A Gueguen
(A)
I Tabellah Kasonde
(IT)
A De Vilmarest
(A)
A Montcuquet
(A)
M Vaillants
(M)
S Beltran
(S)
A Creange
(A)
S Ayache
(S)
M Abdellaoui
(M)
C Pottier
(C)
I Slesari
(I)
V Deburghraeve
(V)
J P Neau
(JP)
J Servan
(J)
F Pico
(F)
C Henry
(C)
K Hankiewicz
(K)
Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2019 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.
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