Please use this identifier to cite or link to this item: http://hdl.handle.net/10668/2601
Título : Comparison of switch to fingolimod or interferon beta/glatiramer acetate in active multiple sclerosis.
Autor : He, Anna
Spelman, Tim
Jokubaitis, Vilija
Havrdova, Eva
Horakova, Dana
Trojano, Maria
Lugaresi, Alessandra
Izquierdo, Guillermo
Grammond, Pierre
Duquette, Pierre
Girard, Marc
Pucci, Eugenio
Iuliano, Gerardo
Alroughani, Raed
Oreja-Guevara, Celia
Fernandez-Bolaños, Ricardo
Grand'Maison, Francois
Sola, Patrizia
Spitaleri, Daniele
Granella, Franco
Terzi, Murat
Lechner-Scott, Jeannette
Van Pesch, Vincent
Hupperts, Raymond
Sánchez-Menoyo, José Luis
Hodgkinson, Suzanne
Rozsa, Csilla
Verheul, Freek
Butzkueven, Helmut
Kalincik, Tomas
Filiación: [He,A; Butzkueven,H; Kalincik,T] Department of Neurology,Royal Melbourne Hospital, Melbourne, Australia. [Spelman,T; Jokubaitis,V; Butzkueven,H; Kalincik,T] Department of Medicine, University of Melbourne, Melbourne, Australia. [Havrdova,E; Horakova,A] Department of Neurology and Center of Clinical Neuroscience, General University Hospital, Prague, Czech Republic. [Havrdova,E; Horakova,A] Department of Neurology and Center for Clinical Neuroscience, Charles University, Prague, Czech Republic. [Trojano,M] Department of Basic Medical Sciences, Neuroscience, and Sense Organs, University of Bari, Bari, Italy. [Lugaresi,A] MS Center, Department of Neuroscience, Imaging, and Clinical Sciences, University G. d’Annunzio, Chienti, Italy. [Izquierdo,G] Department of Neurology, Hospital Universitario Virgen Macarena, Sevilla, Spain. [Grammond,P] Department of Neurology, Hotel-Dieu de Lévis, Lévis, Quebec, Canada. [Duquette,P; Girard,M] Department of Neurology, Hôpital Notre Dame, Montreal, Quebec, Canada. [Pucci,E] Neurology Unit, Azienda Sanitaria Unica Regionale Marche, Macerata, Italy. [Iuliano,G] Department of Neurology, Ospedali Riuniti di Salerno, Salerno, Italy. [Alroughani,R] Department of Neurology, Amiri Hospital, Kuwait City, Kuwait. [Oreja-Guevara,C] Multiple Sclerosis Unit, University Hospital San Carlos, Madrid, Spain. [Fernandez-Bolaños,R] Department of Neurology, Hospital Universitario Virgen de Valme, Seville, Spain. [Grand'Maison,F] Neuro Rive-Sud, Hôpital Charles LeMoyne, Quebec City, Quebec, Canada. [Sola,P] Department of Neurology, Nuovo Ospedale Civile San Agostino, Modena, Italy. [Spitaleri,D] Department of Neurology, Azienda Ospedaliera di Rilievo Nazionale, San Giuseppe Moscati, Avellino, Italy. [Granella,F] Institute of Neurology, University of Parma, Parma, Italy. [Terzi,M] Medical Faculty, Department of Neurology, Ondokuz Mayis University, Samsun, Turkey. [Lechner-Scott,J] Department of Medicine, JohnHunter Hospital, Newcastle, Australia. Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia. [Van Pesch,V] Department of Neurology, Cliniques Universitaires Saint-Luc, Brussels, Belgium. [Hupperts,R] Department of Neurology, Orbis Medical Center, Sittard, the Netherlands. [Sánchez-Menoyo,JL] Department of Neurology, Hospital de Galdakao-Usansolo, Galdakao, Spain. [Hodgkinson,S] Department of Nephrology, Liverpool Hospital, Liverpool, Australia. [Rozsa,C] Department of Neurology, Jahn Ferenc Teaching Hospital,Budapest, Hungary. [Verheul,F] Neurology Unit, Groen Hart Ziekenhuis, Gouda, the Netherlands. [Butzkueven,H] Department of Neurology, Box Hill Hospital, Monash University, Melbourne, Australia.
Grupo de Investigación: MSBase Study Group.
Palabras clave : Factores inmunológicos
Inmunosupresores
Interferón beta
Imagen por resonancia magnética
Glicoles de propileno
Resultado del Tratamiento
Esclerosis Múltiple
MeSH: Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies
Medical Subject Headings::Check Tags::Female
Medical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans
Medical Subject Headings::Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Physiological Effects of Drugs::Immunologic Factors
Medical Subject Headings::Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Physiological Effects of Drugs::Immunologic Factors::Immunosuppressive Agents
Medical Subject Headings::Chemicals and Drugs::Amino Acids, Peptides, and Proteins::Peptides::Intercellular Signaling Peptides and Proteins::Cytokines::Interferons::Interferon Type I::Interferon-beta
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Diagnostic Techniques and Procedures::Diagnostic Imaging::Magnetic Resonance Imaging
Medical Subject Headings::Check Tags::Male
Medical Subject Headings::Diseases::Nervous System Diseases::Demyelinating Diseases::Demyelinating Autoimmune Diseases, CNS::Multiple Sclerosis
Medical Subject Headings::Chemicals and Drugs::Organic Chemicals::Alcohols::Glycols::Propylene Glycols::Fingolimod Hydrochloride
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Case-Control Studies::Retrospective Studies
Medical Subject Headings::Chemicals and Drugs::Organic Chemicals::Alcohols::Amino Alcohols::Sphingosine
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Prognosis::Treatment Outcome
Medical Subject Headings::Named Groups::Persons::Age Groups::Adult
Fecha de publicación : Apr-2015
Editorial : American Medical Association
Cita Bibliográfica: He A, Spelman T, Jokubaitis V, Havrdova E, Horakova D, Trojano M, et al. Comparison of switch to fingolimod or interferon beta/glatiramer acetate in active multiple sclerosis. JAMA Neurol. 2015; 72(4):405-13
Abstract: IMPORTANCE After multiple sclerosis (MS) relapse while a patient is receiving an injectable disease-modifying drug, many physicians advocate therapy switch, but the relative effectiveness of different switch decisions is often uncertain. OBJECTIVE To compare the effect of the oral immunomodulator fingolimod with that of all injectable immunomodulators (interferons or glatiramer acetate) on relapse rate, disability, and treatment persistence in patients with active MS. DESIGN, SETTING, AND PARTICIPANTS Matched retrospective analysis of data collected prospectively from MSBase, an international, observational cohort study. The MSBase cohort represents a population of patients with MS monitored at large MS centers. The analyzed data were collected between July 1996 and April 2014. Participants included patients with relapsing-remitting MS who were switching therapy to fingolimod or injectable immunomodulators up to 12 months after on-treatment clinical disease activity (relapse or progression of disability), matched on demographic and clinical variables. Median follow-up duration was 13.1 months (range, 3-80). Indication and attrition bias were controlled with propensity score matching and pairwise censoring, respectively. Head-to-head analyses of relapse and disability outcomes used paired, weighted, negative binomial models or frailty proportional hazards models adjusted for magnetic resonance imaging variables. Sensitivity analyses were conducted. EXPOSURES Patients had received fingolimod, interferon beta, or glatiramer acetate for a minimum of 3 months following a switch of immunomodulatory therapy. MAIN OUTCOMES AND MEASURES Annualized relapse rate and proportion of relapse-free patients, as well as the proportion of patients without sustained disability progression. RESULTS Overall, 379 patients in the injectable group were matched to 148 patients in the fingolimod group. The fingolimod group had a lower mean annualized relapse rate (0.31 vs 0.42; 95% CI, 0.02-0.19; P=.009), lower hazard of first on-treatment relapse (hazard ratio [HR], 0.74; 95% CI, 0.56-0.98; P=.04), lower hazard of disability progression (HR, 0.53; 95% CI, 0.31-0.91; P=.02), higher rate of disability regression (HR, 2.0; 95% CI, 1.2-3.3; P=.005), and lower hazard of treatment discontinuation (HR, 0.55; P=.04) compared with the injectable group. CONCLUSIONS AND RELEVANCE Switching from injectable immunomodulators to fingolimod is associated with fewer relapses, more favorable disability outcomes, and greater treatment persistence compared with switching to another injectable preparation following on-treatment activity of MS.
Descripción : Comparative Study; Journal Article; Research Support, Non-U.S. Gov't;
URI: http://hdl.handle.net/10668/2601
Versión del editor : http://jamanetwork.com/journals/jamaneurology/fullarticle/2099525
DOI: 10.1001/jamaneurol.2014.4147
ISSN : 2168-6157 (Online)
2168-6149 (Print)
Appears in Collections:01- Artículos - AGS Sur de Sevilla
01- Artículos - Hospital Virgen Macarena

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