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Disability progression in relapse-free multiple sclerosis patients on fingolimod versus interferon-beta/glatiramer

Viktor von Wyl1, Pascal Benkert2, André Moser3

  • 1Department of Epidemiology, Biostatistics and Prevention Institute, University of Zürich, Zürich, Switzerland/ Swiss Multiple Sclerosis Registry, Epidemiology, Biostatistics and Prevention Institute, University of Zürich, Zürich, Switzerland.

Multiple Sclerosis (Houndmills, Basingstoke, England)
|May 29, 2020
PubMed
Abstract

Insights

Fingolimod significantly reduces disability progression in relapsing-remitting multiple sclerosis (RRMS) compared to interferon-beta/glatiramer acetate (IFN/GA). This benefit was observed in both relapsing and relapse-free patients, highlighting fingolimod

Area of Science:

  • Neurology
  • Immunology
  • Clinical Trials

Background:

  • Disability progression independent of relapses (PIRA) is a frequent occurrence in relapsing-remitting multiple sclerosis (RRMS).
  • Understanding factors influencing PIRA is crucial for optimizing treatment strategies in RRMS.

Purpose of the Study:

  • To compare the incidence of disability progression in relapse-free RRMS patients treated with interferon-beta/glatiramer acetate (IFN/GA) versus fingolimod.
  • To evaluate the efficacy of fingolimod in preventing disability progression, considering both relapsing and relapse-free disease courses.

Main Methods:

  • Retrospective analysis of 1640 RRMS patients from Swiss health insurance data.
  • Comparison of time to relapse and 12-month confirmed disability progression using multivariable Cox regression.
  • Application of inverse-probability weighting to correct for biases in treatment group selection.

Main Results:

  • Fingolimod use was associated with a significantly lower frequency of disability progression compared to IFN/GA (HR=0.53).
  • This protective effect of fingolimod remained significant even after bias correction and in relapse-free patients (HR=0.56).
  • Disability progression was observed in 8.8% of IFN/GA patients and 7.6% of fingolimod patients.

Conclusions:

  • Fingolimod demonstrates superior efficacy over IFN/GA in preventing disability progression in young, newly diagnosed RRMS patients.
  • The benefits of fingolimod extend to both relapsing and relapse-free disease states, suggesting a broad impact on disease course.
Keywords:
Multiple sclerosisdisability progressiondisease-modifying therapiesrelapsing/remitting

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