- Title
- Risk of early relapse following the switch from injectables to oral agents for multiple sclerosis
- Creator
- Spelman, T.; Mekhael, L.; Grammond, P.; Barnett, M.; Lechner-Scott, J.; Alroughani, R.; Trojano, M.; Lugaresi, A.; Granella, F.; Pucci, E.; Vucic, S.; Burke, T.; Butzkueven, H.; Hodgkinson, S.; Havrdova, E.; Horakova, D.; Duquette, P.; Izquierdo, G.; Grand'Maison, F.
- Relation
- European Journal of Neurology Vol. 23, Issue 4, p. 729-736
- Publisher Link
- http://dx.doi.org/10.1111/ene.12929
- Publisher
- Wiley-Blackwell Publishing
- Resource Type
- journal article
- Date
- 2016
- Description
- Background and Purpose: Early relapse outcomes in long-term stable patients switching from interferon ß/glatiramer acetate (IFNß/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 IFNß/GA, relative to a propensity-matched comparator of patients remaining on IFNß/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 IFNß/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.
- Subject
- dimethyl fumarate; fingolimod; multiple sclerosis; progression; relapse; teriflunomide; treatment switching
- Identifier
- http://hdl.handle.net/1959.13/1347312
- Identifier
- uon:30017
- Identifier
- ISSN:1351-5101
- Language
- eng
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