- Title
- Cladribine versus fingolimod, natalizumab and interferon β for multiple sclerosis
- Creator
- Kalincik, Tomas; Jokubaitis, Vilja; Duquette, Pierre; Grammond, Pierre; Solaro, Claudio; Grand'Maison, Francois; Hupperts, Raymond; Prevost, Julie; Sola, Patrizia; Ferraro, Diana; Terzi, Murat; Butler, Ernest; Spelman, Tim; Slee, Mark; Kermode, Allan; Fabis-Pedrini, Marzena; McCombe, Pamela; Barnett, Michael; Shaw, Cameron; Hodgkinson, Suzanne; Butzkueven, Helmut; MSBase Study Group,; Horakova, Dana; Havrdova, Eva; Trojano, Maria; Lechner-Scott, Jeannette; Lugaresi, Alessandra; Prat, Alexandre; Girard, Marc
- Relation
- Multiple Sclerosis Journal Vol. 24, Issue 12, p. 1617-1626
- Publisher Link
- http://dx.doi.org/10.1177/1352458517728812
- Publisher
- Sage
- Resource Type
- journal article
- Date
- 2018
- Description
- Objective: This propensity score-matched analysis from MSBase compared the effectiveness of cladribine with interferon β, fingolimod or natalizumab. Methods: We identified all patients with relapse-onset multiple sclerosis, exposure to the study therapies and ≥1-year on-treatment follow-up from MSBase. Three pairwise propensity score-matched analyses compared treatment outcomes over 1 year. The outcomes were hazards of first relapse, disability accumulation and disability improvement events. Sensitivity analyses were completed. Results: The cohorts consisted of 37 (cladribine), 1940 (interferon), 1892 (fingolimod) and 1410 patients (natalizumab). The probability of experiencing a relapse on cladribine was lower than on interferon (p = 0.05), similar to fingolimod (p = 0.31) and higher than on natalizumab (p = 0.042). The probability of disability accumulation on cladribine was similar to interferon (p = 0.37) and fingolimod (p = 0.089) but greater than natalizumab (p = 0.021). The probability of disability improvement was higher on cladribine than interferon (p = 0.00017), fingolimod (p = 0.0025) or natalizumab (p = 0.00099). Sensitivity analyses largely confirmed the above results. Conclusion: Cladribine is an effective therapy for relapse-onset multiple sclerosis. Its effect on relapses is comparable to fingolimod and its effect on disability accrual is comparable to interferon β and fingolimod. Cladribine may potentially associate with superior recovery from disability relative to interferon, fingolimod and natalizumab.
- Subject
- cladribine; interferon; fingolimod; natalizumab; relapses; disability
- Identifier
- http://hdl.handle.net/1959.13/1414403
- Identifier
- uon:36736
- Identifier
- ISSN:1477-0970
- Language
- eng
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