Comparative treatment effectiveness of oral fingolimod and conventional injectable disease-modifying agents in multiple sclerosis.
Pharmacotherapy
; 41(5): 440-450, 2021 05.
Article
en En
| MEDLINE
| ID: mdl-33641232
ABSTRACT
STUDY OBJECTIVE:
To compare the effectiveness of oral fingolimod and conventional injectable disease-modifying agents (DMAs) using the composite endpoint of relapse or DMA treatment switch in patients with multiple sclerosis (MS).DESIGN:
A retrospective longitudinal cohort study. DATA SOURCE IBM MarketScan Commercial Claims and Encounters Database from 2010-2012. PATIENTS Adults (≥18 years) with MS diagnosis (ICD-9-CM340) who newly initiated DMAs. INTERVENTION Oral fingolimod and conventional injectable DMAs (interferon beta and glatiramer acetate). MEASUREMENTS Composite endpoint of time to relapse or DMA treatment switch. MAINRESULTS:
The incident study cohort consisted of 1997 MS patients who initiated oral fingolimod (15.6%) or injectable (84.4%) DMAs. The proportion of patients who had a composite endpoint (relapse/DMA treatment switch) in oral fingolimod and injectable DMA users was found to be 16.72% and 27.16%, respectively. The Cox PH regression model with stabilized IPTW revealed that fingolimod is equally effective as conventional injectable DMAs in reducing the risk of experiencing the composite endpoint of relapse or DMA switch (adjusted hazard ratio [aHR] 0.67, 95% CI 0.43-1.03). Additional analysis among patients who were adherent also found no significant difference in the composite endpoint (aHR 0.70, 95% CI 0.49-1.15) between oral fingolimod and injectable DMA users.CONCLUSIONS:
Oral fingolimod has similar effectiveness as conventional injectable DMAs in reducing the risk of experiencing the composite endpoint (relapse or DMA treatment switch). In addition, when assessed independently, oral fingolimod showed no difference in reducing the time to relapse or DMA treatment switch compared to injectable DMAs.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Clorhidrato de Fingolimod
/
Esclerosis Múltiple
Tipo de estudio:
Observational_studies
/
Risk_factors_studies
Límite:
Adult
/
Humans
Idioma:
En
Revista:
Pharmacotherapy
Año:
2021
Tipo del documento:
Article
País de afiliación:
Estados Unidos