Objective: To compare treatment efficacy and persistence in patients whoswitched to natalizumab versus those who switched between glatiramer acetate(GA) and interferon-beta (IFNb) after an on-treatment relapse on IFNb or GAusing propensity score matched real-world datasets. Methods: Patients includedwere registered in MSBase or the TYSABRI Observational Program (TOP), hadrelapsed on IFNb or GA within 12 months prior to switching to another ther-apy, and had initiated natalizumab or IFNb/GA treatment ≤6 months afterdiscontinuing prior therapy. Covariates were balanced across post switch treat-ment groups by propensity score matching at treatment initiation. Relapse, per-sistence, and disability measures were compared between matched treatmentarms in the total population (n = 869/group) and in subgroups defined by priortreatment history (IFNb only [n = 578/group], GA only [n = 165/group], orboth IFNb and GA [n = 176/group]). Results: Compared to switching betweenIFNb and GA, switching to natalizumab reduced annualized relapse rate inyear one by 65–75%, the risk of first relapse by 53–82% (mean follow-up1.7–2.2 years) and treatment discontinuation events by 48–65% (all P ≤ 0.001).In the total population, switching to natalizumab reduced the risk of confirmeddisability progression by 26% (P = 0.036) and decreased the total disability bur-den by 1.54 EDSS-years (P < 0.0001) over the first 24 months post switch. Interpretation: Using large, real-world, propensity-matched datasets we demon-strate that after a relapse on IFN b or GA, switching to natalizumab (rather thanbetween IFNb and GA) led to superior outcomes for patients in all measuresassessed. Results were consistent regardless of the prior treatment identity.

Comparative efficacy of switching to natalizumab in active multiple sclerosis

LUGARESI, Alessandra;
2015-01-01

Abstract

Objective: To compare treatment efficacy and persistence in patients whoswitched to natalizumab versus those who switched between glatiramer acetate(GA) and interferon-beta (IFNb) after an on-treatment relapse on IFNb or GAusing propensity score matched real-world datasets. Methods: Patients includedwere registered in MSBase or the TYSABRI Observational Program (TOP), hadrelapsed on IFNb or GA within 12 months prior to switching to another ther-apy, and had initiated natalizumab or IFNb/GA treatment ≤6 months afterdiscontinuing prior therapy. Covariates were balanced across post switch treat-ment groups by propensity score matching at treatment initiation. Relapse, per-sistence, and disability measures were compared between matched treatmentarms in the total population (n = 869/group) and in subgroups defined by priortreatment history (IFNb only [n = 578/group], GA only [n = 165/group], orboth IFNb and GA [n = 176/group]). Results: Compared to switching betweenIFNb and GA, switching to natalizumab reduced annualized relapse rate inyear one by 65–75%, the risk of first relapse by 53–82% (mean follow-up1.7–2.2 years) and treatment discontinuation events by 48–65% (all P ≤ 0.001).In the total population, switching to natalizumab reduced the risk of confirmeddisability progression by 26% (P = 0.036) and decreased the total disability bur-den by 1.54 EDSS-years (P < 0.0001) over the first 24 months post switch. Interpretation: Using large, real-world, propensity-matched datasets we demon-strate that after a relapse on IFN b or GA, switching to natalizumab (rather thanbetween IFNb and GA) led to superior outcomes for patients in all measuresassessed. Results were consistent regardless of the prior treatment identity.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11564/624711
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