TY - JOUR
T1 - Comparative efficacy of switching to natalizumab in active multiple sclerosis
AU - Spelman, Timothy
AU - Kalincik, Tomas
AU - Zhang, Annie
AU - Pellegrini, Fabio
AU - Wiendl, Heinz
AU - Kappos, Ludwig
AU - Tsvetkova, Larisa
AU - Belachew, Shibeshih
AU - Hyde, Robert
AU - Verheul, Freek
AU - Grand-Maison, Francois
AU - Izquierdo, Guillermo
AU - Grammond, Pierre
AU - Duquette, Pierre
AU - Lugaresi, Alessandra
AU - Lechner-Scott, Jeannette
AU - Oreja-Guevara, Celia
AU - Hupperts, Raymond
AU - Petersen, Thor
AU - Barnett, Michael
AU - Trojano, Maria
AU - Butzkueven, Helmut
PY - 2015/4
Y1 - 2015/4
N2 - To compare treatment efficacy and persistence in patients who switched to natalizumab versus those who switched between glatiramer acetate (GA) and interferon-beta (IFN?) after an on-treatment relapse on IFN? or GA using propensity score matched real-world datasets.Patients included were registered in MSBase or the TYSABRI Observational Program (TOP), had relapsed on IFN? or GA within 12?months prior to switching to another therapy, and had initiated natalizumab or IFN?/GA treatment ?6?months after discontinuing prior therapy. Covariates were balanced across post switch treatment groups by propensity score matching at treatment initiation. Relapse, persistence, and disability measures were compared between matched treatment arms in the total population (n?=?869/group) and in subgroups defined by prior treatment history (IFN? only [n?=?578/group], GA only [n?=?165/group], or both IFN? and GA [n?=?176/group]).Compared to switching between IFN? and GA, switching to natalizumab reduced annualized relapse rate in year?one by 65-75%, the risk of first relapse by 53-82% (mean follow-up 1.7-2.2?years) and treatment discontinuation events by 48-65% (all P?0.001). In the total population, switching to natalizumab reduced the risk of confirmed disability progression by 26% (P?=?0.036) and decreased the total disability burden by 1.54 EDSS-years (P?
AB - To compare treatment efficacy and persistence in patients who switched to natalizumab versus those who switched between glatiramer acetate (GA) and interferon-beta (IFN?) after an on-treatment relapse on IFN? or GA using propensity score matched real-world datasets.Patients included were registered in MSBase or the TYSABRI Observational Program (TOP), had relapsed on IFN? or GA within 12?months prior to switching to another therapy, and had initiated natalizumab or IFN?/GA treatment ?6?months after discontinuing prior therapy. Covariates were balanced across post switch treatment groups by propensity score matching at treatment initiation. Relapse, persistence, and disability measures were compared between matched treatment arms in the total population (n?=?869/group) and in subgroups defined by prior treatment history (IFN? only [n?=?578/group], GA only [n?=?165/group], or both IFN? and GA [n?=?176/group]).Compared to switching between IFN? and GA, switching to natalizumab reduced annualized relapse rate in year?one by 65-75%, the risk of first relapse by 53-82% (mean follow-up 1.7-2.2?years) and treatment discontinuation events by 48-65% (all P?0.001). In the total population, switching to natalizumab reduced the risk of confirmed disability progression by 26% (P?=?0.036) and decreased the total disability burden by 1.54 EDSS-years (P?
U2 - 10.1002/acn3.180
DO - 10.1002/acn3.180
M3 - Article
C2 - 25909083
SN - 2328-9503
VL - 2
SP - 373
EP - 387
JO - Annals of Clinical and Translational Neurology
JF - Annals of Clinical and Translational Neurology
IS - 4
ER -