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Comparison of fingolimod, dimethyl fumarate and teriflunomide for multiple sclerosis.
Kalincik, Tomas; Kubala Havrdova, Eva; Horakova, Dana; Izquierdo, Guillermo; Prat, Alexandre; Girard, Marc; Duquette, Pierre; Grammond, Pierre; Onofrj, Marco; Lugaresi, Alessandra; Ozakbas, Serkan; Kappos, Ludwig; Kuhle, Jens; Terzi, Murat; Lechner-Scott, Jeannette; Boz, Cavit; Grand'Maison, Francois; Prevost, Julie; Sola, Patrizia; Ferraro, Diana; Granella, Franco; Trojano, Maria; Bergamaschi, Roberto; Pucci, Eugenio; Turkoglu, Recai; McCombe, Pamela A; Pesch, Vincent Van; Van Wijmeersch, Bart; Solaro, Claudio; Ramo-Tello, Cristina; Slee, Mark; Alroughani, Raed; Yamout, Bassem; Shaygannejad, Vahid; Spitaleri, Daniele; Sánchez-Menoyo, José Luis; Ampapa, Radek; Hodgkinson, Suzanne; Karabudak, Rana; Butler, Ernest; Vucic, Steve; Jokubaitis, Vilija; Spelman, Tim; Butzkueven, Helmut.
Afiliación
  • Kalincik T; CORe, Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia tomas.kalincik@unimelb.edu.au.
  • Kubala Havrdova E; Department of Neurology, Royal Melbourne Hospital, Melbourne, Victoria, Australia.
  • Horakova D; Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic.
  • Izquierdo G; Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic.
  • Prat A; Hospital Universitario Virgen Macarena, Sevilla, Spain.
  • Girard M; Montreal, Quebec, Hopital Notre-Dame, Canada.
  • Duquette P; CHUM and Universite de Montreal, Montreal, Quebec, Canada.
  • Grammond P; Montreal, Quebec, Hopital Notre-Dame, Canada.
  • Onofrj M; CHUM and Universite de Montreal, Montreal, Quebec, Canada.
  • Lugaresi A; Montreal, Quebec, Hopital Notre-Dame, Canada.
  • Ozakbas S; CHUM and Universite de Montreal, Montreal, Quebec, Canada.
  • Kappos L; CISSS de Chaudière-Appalaches, Levis, Quebec, Canada.
  • Kuhle J; Department of Neuroscience, Imaging, and Clinical Sciences, University G d'Annunzio, Chieti, Italy.
  • Terzi M; Bologna, IRCCS Istituto delle Scienze Neurologiche di Bologna, Italy.
  • Lechner-Scott J; Department of Biomedical and Neuromotor Science, University of Bologna, Bologna, Italy.
  • Boz C; Dokuz Eylul University, Izmir, Turkey.
  • Grand'Maison F; Neurologic Clinic and Policlinic, Departments of Medicine and Clinical Research, University Hospital and University of Basel, Basel, Switzerland.
  • Prevost J; Neurologic Clinic and Policlinic, Departments of Medicine and Clinical Research, University Hospital and University of Basel, Basel, Switzerland.
  • Sola P; Medical Faculty, 19 Mayis University, Samsun, Turkey.
  • Ferraro D; School of Medicine and Public Health, University Newcastle, Newcastle, New South Wales, Australia.
  • Granella F; Department of Neurology, John Hunter Hospital, Hunter New England Health, Newcastle, New South Wales, Australia.
  • Trojano M; KTU Medical Faculty Farabi Hospital, Trabzon, Turkey.
  • Bergamaschi R; Neuro Rive-Sud, Quebec City, Quebec, Canada.
  • Pucci E; CSSS Saint-Jérôme, Saint-Jerome, Quebec, Canada.
  • Turkoglu R; Department of Neuroscience, Azienda Ospedaliera Universitaria, Modena, Italy.
  • McCombe PA; Department of Neuroscience, Azienda Ospedaliera Universitaria, Modena, Italy.
  • Pesch VV; Department of Medicine and Surgery, University of Parma, Parma, Italy.
  • Van Wijmeersch B; Department of Emergency and General Medicine, Parma University Hospital, Parma, Italy.
  • Solaro C; Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari, Bari, Italy.
  • Ramo-Tello C; IRCCS Mondino Foundation, Pavia, Italy.
  • Slee M; UOC Neurologia, Azienda Sanitaria Unica Regionale Marche-AV3, Macerata, Italy.
  • Alroughani R; Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey.
  • Yamout B; Royal Brisbane and Women's Hospital, University of Queensland, Brisbane, Queensland, Australia.
  • Shaygannejad V; Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium.
  • Spitaleri D; Rehabilitation and MS-Centre Overpelt and Hasselt University, Hasselt, Belgium.
  • Sánchez-Menoyo JL; Department of Neurology, ASL3 Genovese, and Department of Rehabilitation, ML Novarese Hospital Moncrivello, Genova, Italy.
  • Ampapa R; Hospital Germans Trias i Pujol, Badalona, Spain.
  • Hodgkinson S; Flinders University, Adelaide, South Australia, Australia.
  • Karabudak R; Division of Neurology, Department of Medicine, Amiri Hospital, Sharq, Kuwait.
  • Butler E; Nehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut Medical Center, Beirut, Lebanon.
  • Vucic S; Isfahan University of Medical Sciences, Isfahan, Iran.
  • Jokubaitis V; Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati Avellino, Avellino, Italy.
  • Spelman T; Hospital de Galdakao-Usansolo, Galdakao, Spain.
  • Butzkueven H; Nemocnice Jihlava, Jihlava, Czech Republic.
J Neurol Neurosurg Psychiatry ; 90(4): 458-468, 2019 04.
Article en En | MEDLINE | ID: mdl-30636699
OBJECTIVE: Oral immunotherapies have become a standard treatment in relapsing-remitting multiple sclerosis. Direct comparison of their effect on relapse and disability is needed. METHODS: We identified all patients with relapsing-remitting multiple sclerosis treated with teriflunomide, dimethyl fumarate or fingolimod, with minimum 3-month treatment persistence and disability follow-up in the global MSBase cohort study. Patients were matched using propensity scores. Three pairwise analyses compared annualised relapse rates and hazards of disability accumulation, disability improvement and treatment discontinuation (analysed with negative binomial models and weighted conditional survival models, with pairwise censoring). RESULTS: The eligible cohorts consisted of 614 (teriflunomide), 782 (dimethyl fumarate) or 2332 (fingolimod) patients, followed over the median of 2.5 years. Annualised relapse rates were lower on fingolimod compared with teriflunomide (0.18 vs 0.24; p=0.05) and dimethyl fumarate (0.20 vs 0.26; p=0.01) and similar on dimethyl fumarate and teriflunomide (0.19 vs 0.22; p=0.55). No differences in disability accumulation (p≥0.59) or improvement (p≥0.14) were found between the therapies. In patients with ≥3-month treatment persistence, subsequent discontinuations were less likely on fingolimod than teriflunomide and dimethyl fumarate (p<0.001). Discontinuation rates on teriflunomide and dimethyl fumarate were similar (p=0.68). CONCLUSION: The effect of fingolimod on relapse frequency was superior to teriflunomide and dimethyl fumarate. The effect of the three oral therapies on disability outcomes was similar during the initial 2.5 years on treatment. Persistence on fingolimod was superior to the two comparator drugs.
Asunto(s)

Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Toluidinas / Crotonatos / Esclerosis Múltiple Recurrente-Remitente / Clorhidrato de Fingolimod / Dimetilfumarato / Inmunosupresores Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: J Neurol Neurosurg Psychiatry Año: 2019 Tipo del documento: Article País de afiliación: Australia

Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Toluidinas / Crotonatos / Esclerosis Múltiple Recurrente-Remitente / Clorhidrato de Fingolimod / Dimetilfumarato / Inmunosupresores Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: J Neurol Neurosurg Psychiatry Año: 2019 Tipo del documento: Article País de afiliación: Australia