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Title: | Cladribine versus fingolimod, natalizumab and interferon beta for multiple sclerosis. | Authors: | Girard M.;Kalincik T.;Jokubaitis V.;Spelman T.;Horakova D.;Havrdova E.;Trojano M.;Lechner-Scott J.;Lugaresi A.;Prat A.;Prevost J.;Sola P.;Ferraro D.;Terzi M.;Butler E. ;Slee M.;Kermode A.;Fabis-Pedrini M.;McCombe P.;Barnett M.;Shaw C.;Hodgkinson S.;Butzkueven H.;Duquette P.;Grammond P.;Solaro C.;Grand'Maison F.;Hupperts R. | Institution: | (Kalincik) CORe, Department of Medicine, The University of Melbourne, Melbourne, VIC, Australia (Jokubaitis, Spelman) Department of Neurology, The Royal Melbourne Hospital, Melbourne, VIC, Australia (Horakova, Havrdova) Department of Neurology and Center of Clinical Neuroscience, General University Hospital and Charles University in Prague, Prague, Czechia (Trojano) Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari, Bari, Italy (Lechner-Scott) The University of Newcastle, Newcastle, NSW, Australia (Lugaresi) Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio", Chieti, Italy (Prat, Girard, Duquette) Hopital Notre-Dame, Montreal, QC, Canada (Grammond) CISSS de Chaudiere-Appalache, Levis, QC, Canada (Solaro) Ospedale Padre Antero Micone, Genoa, Italy (Grand'Maison) Clinique Neuro Rive-Sud, Greenfield Park, QC, Canada (Hupperts) Zuyderland Ziekenhuis, Sittard, Netherlands (Prevost) CSSS de Saint-Jerome, Saint-Jerome, QC, Canada (Sola, Ferraro) Nuovo Ospedale Civile Sant'Agostino-Estense, Modena, Italy (Terzi) Medical Faculty, 19 Mayis University, Samsun, Turkey (Butler) Monash Medical Centre, Melbourne, VIC, Australia (Slee) Flinders University, Adelaide, SA, Australia (Kermode) The Perron Institute, The University of Western Australia, Perth, WA, Australia (Fabis-Pedrini) The Perron Institute, The University of Western Australia, Perth, WA, Australia (McCombe) The University of Queensland, Brisbane, QLD, Australia (Barnett) Brain and Mind Centre, Sydney, NSW, Australia (Shaw) Geelong Hospital, Geelong, VIC, Australia (Hodgkinson) Liverpool Hospital, Sydney, NSW, Australia (Butzkueven) Department of Neurology, The Royal Melbourne Hospital, Melbourne, VIC, Australia (Kalincik) Department of Neurology, The Royal Melbourne Hospital, Melbourne, VIC, Australia (Lugaresi) Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy (Lugaresi) IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy (Kermode) Institute for Immunology and Infectious Diseases, Murdoch University, Perth, WA, Australia (Butzkueven) Department of Medicine, The University of Melbourne, Melbourne, VIC, Australia (Butzkueven) Department of Neurology, Box Hill Hospital, Monash University, Melbourne, VIC, Australia (McCombe) Royal Brisbane and Women's Hospital, Herston, QLD, Australia (Prat, Girard, Duquette) CHUM, Universite de Montreal, Montreal, QC, Canada (Jokubaitis, Spelman) Department of Medicine, The University of Melbourne, Melbourne, VIC, Australia | Issue Date: | 29-Oct-2018 | Copyright year: | 2018 | Publisher: | SAGE Publications Ltd (E-mail: info@sagepub.co.uk) | Place of publication: | United Kingdom | Publication information: | Multiple Sclerosis Journal. 24 (12) (pp 1617-1626), 2018. Date of Publication: 01 Oct 2018. | Journal: | Multiple Sclerosis Journal | Abstract: | Objective: This propensity score-matched analysis from MSBase compared the effectiveness of cladribine with interferon beta, fingolimod or natalizumab. Method(s): We identified all patients with relapse-onset multiple sclerosis, exposure to the study therapies and 1-year on-treatment follow-up from MSBase. Three pairwise propensity score-matched analyses compared treatment outcomes over 1 year. The outcomes were hazards of first relapse, disability accumulation and disability improvement events. Sensitivity analyses were completed. Result(s): The cohorts consisted of 37 (cladribine), 1940 (interferon), 1892 (fingolimod) and 1410 patients (natalizumab). The probability of experiencing a relapse on cladribine was lower than on interferon (p = 0.05), similar to fingolimod (p = 0.31) and higher than on natalizumab (p = 0.042). The probability of disability accumulation on cladribine was similar to interferon (p = 0.37) and fingolimod (p = 0.089) but greater than natalizumab (p = 0.021). The probability of disability improvement was higher on cladribine than interferon (p = 0.00017), fingolimod (p = 0.0025) or natalizumab (p = 0.00099). Sensitivity analyses largely confirmed the above results. Conclusion(s): Cladribine is an effective therapy for relapse-onset multiple sclerosis. Its effect on relapses is comparable to fingolimod and its effect on disability accrual is comparable to interferon beta and fingolimod. Cladribine may potentially associate with superior recovery from disability relative to interferon, fingolimod and natalizumab.Copyright © The Author(s), 2017. | DOI: | http://monash.idm.oclc.org/login?url=http://dx.doi.org/10.1177/1352458517728812 | Link to associated publication: | Click here for full text options | ISSN: | 1352-4585 | URI: | https://repository.monashhealth.org/monashhealthjspui/handle/1/38597 | Type: | Article | Subjects: | *fingolimod/cm [Drug Comparison] adult article cohort analysis controlled study *drug efficacy drug exposure female follow up human major clinical study male middle aged *multiple sclerosis/dt [Drug Therapy] sensitivity analysis treatment duration treatment outcome *beta1a interferon/cm [Drug Comparison] *beta1a interferon/dt [Drug Therapy] *beta1a interferon/sc [Subcutaneous Drug Administration] *cladribine/cm [Drug Comparison] *cladribine/dt [Drug Therapy] *cladribine/po [Oral Drug Administration] *fingolimod/dt [Drug Therapy] *fingolimod/po [Oral Drug Administration] *natalizumab/cm [Drug Comparison] *natalizumab/dt [Drug Therapy] *natalizumab/iv [Intravenous Drug Administration] recombinant beta interferon major clinical study male middle aged *multiple sclerosis / *drug therapy sensitivity analysis treatment duration treatment outcome Article adult cohort analysis controlled study *drug efficacy drug exposure female follow up human |
Type of Clinical Study or Trial: | Observational study (cohort, case-control, cross sectional or survey) |
Appears in Collections: | Articles |
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