Comparative analysis of fingolimod versus teriflunomide in relapsing-remitting multiple sclerosis.

Adult Crotonates / administration & dosage Female Fingolimod Hydrochloride / administration & dosage Humans Hydroxybutyrates Immunologic Factors / administration & dosage Male Middle Aged Multiple Sclerosis, Relapsing-Remitting / diagnostic imaging Nitriles Outcome Assessment, Health Care Propensity Score Retrospective Studies Secondary Prevention Severity of Illness Index Toluidines / administration & dosage

Journal

Multiple sclerosis and related disorders

ISSN: 2211-0356

Titre abrégé: Mult Scler Relat Disord

Pays: Netherlands

ID NLM: 101580247

Informations de publication

Date de publication:
Nov 2019

Historique:

received: 17 01 2019

revised: 17 07 2019

accepted: 25 08 2019

pubmed: 2 9 2019

medline: 20 5 2020

entrez: 2 9 2019

Statut: ppublish

Résumé

Fingolimod and teriflunomide are commonly used in the treatment of relapsing-remitting multiple sclerosis (RRMS). These have not been compared in controlled trials, but only in observational studies, with inconclusive results. Comparison of their effect on relapse and disability in a real-world setting is therefore needed. The objective of this study was to compare the efficacy of fingolimod and teriflunomide in reducing disease activity in RRMS. This multicenter, retrospective observational study was carried out with prospectively collected data from 15 centers. All consecutive RRMS patients treated with teriflunomide or fingolimod were included. Data for relapses, Expanded Disability Status Scale (EDSS) scores and brain magnetic resonance imaging (MRI) scans were collected. Patients were matched using propensity scores. Annualized relapse rates (ARR), disability accumulation, percentage of patients with active MRI and treatment discontinuation over a median 2.5-year follow-up period were compared. Propensity score matching retained 349 out of 1388 patients in the fingolimod group and 349 out 678 in the teriflunomide group for final analyses. Mean ARR decreased markedly from baseline after 1 and 2 years of treatment in both the fingolimod (0.58-0.17 after 1 year and 0.11 after 2 years, p < 0.001) and teriflunomide (0.56-0.29 after 1 year and 0.31 after 2 years, p < 0.001) groups. Mean ARR was lower in fingolimod-treated patients than in those treated with teriflunomide at years 1 (p = 0.02) and 2 (p = 0.004). Compared to teriflunomide, the fingolimod group exhibited a higher percentage of relapse-free patients and a lower percentage of MRI-active patients after 2.5-year follow-up. Disability worsening was similar between the two groups. Patients were less likely to discontinue fingolimod than teriflunomide (p < 0.001). Fingolimod was associated with a better relapse control and lower discontinuation rate than teriflunomide. The two oral therapies exhibited similar effects on disability outcomes.

Sections du résumé

BACKGROUND BACKGROUND

OBJECTIVES OBJECTIVE

The objective of this study was to compare the efficacy of fingolimod and teriflunomide in reducing disease activity in RRMS.

METHODS METHODS

This multicenter, retrospective observational study was carried out with prospectively collected data from 15 centers. All consecutive RRMS patients treated with teriflunomide or fingolimod were included. Data for relapses, Expanded Disability Status Scale (EDSS) scores and brain magnetic resonance imaging (MRI) scans were collected. Patients were matched using propensity scores. Annualized relapse rates (ARR), disability accumulation, percentage of patients with active MRI and treatment discontinuation over a median 2.5-year follow-up period were compared.

RESULTS RESULTS

Propensity score matching retained 349 out of 1388 patients in the fingolimod group and 349 out 678 in the teriflunomide group for final analyses. Mean ARR decreased markedly from baseline after 1 and 2 years of treatment in both the fingolimod (0.58-0.17 after 1 year and 0.11 after 2 years, p < 0.001) and teriflunomide (0.56-0.29 after 1 year and 0.31 after 2 years, p < 0.001) groups. Mean ARR was lower in fingolimod-treated patients than in those treated with teriflunomide at years 1 (p = 0.02) and 2 (p = 0.004). Compared to teriflunomide, the fingolimod group exhibited a higher percentage of relapse-free patients and a lower percentage of MRI-active patients after 2.5-year follow-up. Disability worsening was similar between the two groups. Patients were less likely to discontinue fingolimod than teriflunomide (p < 0.001).

CONCLUSION CONCLUSIONS

Fingolimod was associated with a better relapse control and lower discontinuation rate than teriflunomide. The two oral therapies exhibited similar effects on disability outcomes.

Identifiants

DOI: 10.1016/j.msard.2019.101376 PMID: 31473488

pubmed: 31473488

pii: S2211-0348(19)30353-0

doi: 10.1016/j.msard.2019.101376

pii:

doi:

Substances chimiques

Crotonates 0

Hydroxybutyrates 0

Immunologic Factors 0

Nitriles 0

Toluidines 0

teriflunomide 1C058IKG3B

Fingolimod Hydrochloride G926EC510T

Types de publication

Comparative Study Journal Article Multicenter Study Observational Study

Langues

eng

Sous-ensembles de citation

Pagination

101376