Lower risk for conversion for initial treatment with fingolimod, alemtuzumab, or natalizumab
WEDNESDAY, Jan. 16, 2019 (HealthDay News) — For relapsing-remitting multiple sclerosis (MS), the risk for conversion to secondary progressive MS is lower with initial treatment with fingolimod, alemtuzumab, or natalizumab versus glatiramer acetate or interferon beta, according to a study published online in the Jan. 15 issue of the Journal of the American Medical Association.
J. William L. Brown, M.B.B.S., from the University of Cambridge in the United Kingdom, and colleagues conducted a cohort study with prospective data from 68 neurology centers in 21 countries. They included 1,555 patients with relapsing-remitting MS commencing disease-modifying treatments or clinical monitoring between 1998 and 2012 with a minimum of four years of follow-up.
The researchers found that the risk for conversion to secondary progressive MS was lower for patients initially treated with glatiramer acetate or interferon beta (hazard ratio, 0.71) and for fingolimod-, natalizumab-, and alemtuzumab-treated patients (hazard ratios, 0.37, 0.61, and 0.52, respectively) compared with matched untreated patients. Compared with initial treatment with glatiramer acetate or interferon beta, the risk for conversion was lower with fingolimod, alemtuzumab, or natalizumab (hazard ratio, 0.66). When glatiramer acetate or interferon beta was started within five years of disease onset versus later, the probability of conversion was lower (hazard ratio, 0.77).
“These findings, considered along with the risks associated with these therapies, may help inform decisions regarding disease-modifying treatment selection for patients with relapsing-remitting MS,” the authors write.
Several authors disclosed financial ties to the pharmaceutical industry.
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