Comparative efficacy of switching to natalizumab in active multiple sclerosis

Timothy Spelman*, Tomas Kalincik, Annie Zhang, Fabio Pellegrini, Heinz Wiendl, Ludwig Kappos, Larisa Tsvetkova, Shibeshih Belachew, Robert Hyde, Freek Verheul, Francois Grand-Maison, Guillermo Izquierdo, Pierre Grammond, Pierre Duquette, Alessandra Lugaresi, Jeannette Lechner-Scott, Celia Oreja-Guevara, Raymond Hupperts, Thor Petersen, Michael BarnettMaria Trojano, Helmut Butzkueven

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


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?
Original languageEnglish
Pages (from-to)373-387
JournalAnnals of Clinical and Translational Neurology
Issue number4
Publication statusPublished - Apr 2015


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