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Updated: Dec 12, 2025

Determining Immune System Suppression versus CNS Protection for Pharmacological Interventions in Autoimmune Demyelination
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First-ever treatment in multiple sclerosis.

V Pantazou1, C Pot1, R Du Pasquier1

  • 1Division of Neurology, Department of Clinical Neurosciences, Lausanne University Hospital, University of Lausanne, CHUV, 1005 Lausanne, Switzerland.

Revue Neurologique
|August 11, 2020
PubMed
Summary
This summary is machine-generated.

Fingolimod (FTY) and dimethyl fumarate (DMF) show comparable long-term efficacy and tolerance in early multiple sclerosis (MS) treatment. Both therapies effectively reduce relapses and new MRI lesions, supporting early immunomodulation in MS care.

Keywords:
Dimethyl fumarateDisease modifying treatmentFingolimodMultiple sclerosisReal-world study

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Area of Science:

  • Neurology
  • Immunology
  • Clinical Trials

Background:

  • The real-world multiple sclerosis (MS) patient population differs significantly from those in clinical trials.
  • Early intervention with disease-modifying therapies is crucial for managing MS progression.

Purpose of the Study:

  • To evaluate the long-term efficacy and tolerance of fingolimod (FTY) and dimethyl fumarate (DMF) as first-line treatments.
  • To compare outcomes in treatment-naïve MS patients initiated on FTY or DMF within 36 months of disease onset.

Main Methods:

  • Retrospective analysis of 75 MS patients from a prospective registry.
  • Inclusion criteria: first-line FTY or DMF, treatment initiation within 36 months of disease onset, and >12 months treatment duration.
  • Comparison of clinical and MRI outcomes between FTY and DMF groups.

Main Results:

  • Both FTY and DMF significantly reduced relapses and new T1 Gd-enhancing lesions (P<0.001).
  • No significant difference in NEDA-3 status achievement between FTY (54.5%) and DMF (65%) groups (P=0.444).
  • Disease activity was the primary reason for treatment discontinuation for both drugs.

Conclusions:

  • FTY and DMF demonstrate efficacy and good tolerance in early-treated, treatment-naïve MS patients.
  • Findings support the benefit of early immunomodulatory treatment in MS.
  • FTY was more frequently prescribed, particularly for patients with higher baseline disease activity.