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The comparative effectiveness of fingolimod, natalizumab, and ocrelizumab in relapsing-remitting multiple sclerosis

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dc.contributor.authorAĞAN YILDIRIM, KADRİYE
dc.contributor.authorsBOZ C., ÖZAKBAŞ S., Terzi M., KARABUDAK R., Sevim S., Turkoglu R., Soysal A., Balcı B. P., EFENDİ H., TURAN Ö. F., et al.
dc.date.accessioned2023-02-07T07:54:58Z
dc.date.available2023-02-07T07:54:58Z
dc.date.issued2023-01-01
dc.description.abstract© 2023, Fondazione Società Italiana di Neurologia.Background: Fingolimod, natalizumab, and ocrelizumab are commonly used in the second-line treatment of relapsing-remitting multiple sclerosis (RRMS). However, these have only been compared in observational studies, not in controlled trials, with limited and inconclusive results being reported. A comparison of their effect on relapse and disability in a real-world setting is therefore needed. Objectives: The objective of this study was to compare the efficacy of fingolimod, natalizumab, and ocrelizumab in reducing disease activity in RRMS. Methods: This multicenter, retrospective observational study was carried out with prospectively collected data from 16 centers. All consecutive RRMS patients treated with fingolimod, natalizumab, and ocrelizumab were included. Data for relapses, Expanded Disability Status Scale (EDSS) scores, and brain magnetic resonance imaging (MRI) scans were collected. Patients were matched using propensity scores. Annualized relapse rates (ARR), time to first relapse, and disability accumulation were compared. Results: Propensity score matching retained 736 patients in the fingolimod versus 370 in the natalizumab groups, 762 in the fingolimod versus 434 in the ocrelizumab groups, and 310 in the natalizumab versus 310 in the ocrelizumab groups for final analyses. Mean ARR decreased markedly from baseline after treatment in all three treatment groups. Mean on-treatment ARR was lower in natalizumab-treated patients (0.09, 95% confidence interval (CI), 0.07–0.12) than in those treated with fingolimod (0.17, 0.15–0.19, p<0.001), ocrelizumab (0.08, 0.06–0.11), and fingolimod (0.14, 0.12–0.16, p=0.001). No significant difference was observed in mean on-treatment ARR between patients treated with natalizumab (0.08, 0.06–0.11) and ocrelizumab (0.09, 0.07–0.12, p=0.54). Compared to fingolimod, the natalizumab and ocrelizumab groups exhibited a higher percentage of relapse-free patients and a lower percentage of MRI-active patients at year 1. No significance differences in disability accumulation were determined between the therapies. Conclusion: Natalizumab and ocrelizumab exhibited similar effects on relapse control, and both were associated with better relapse control than fingolimod. The effects of the three therapies on disability outcomes were similar.
dc.identifier.citationBOZ C., ÖZAKBAŞ S., Terzi M., KARABUDAK R., Sevim S., Turkoglu R., Soysal A., Balcı B. P., EFENDİ H., TURAN Ö. F., et al., "The comparative effectiveness of fingolimod, natalizumab, and ocrelizumab in relapsing-remitting multiple sclerosis", Neurological Sciences, 2023
dc.identifier.doi10.1007/s10072-023-06608-z
dc.identifier.issn1590-1874
dc.identifier.urihttps://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85146757912&origin=inward
dc.identifier.urihttps://hdl.handle.net/11424/285996
dc.language.isoeng
dc.relation.ispartofNeurological Sciences
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectTıp
dc.subjectDahili Tıp Bilimleri
dc.subjectDermatoloji
dc.subjectNöroloji
dc.subjectSağlık Bilimleri
dc.subjectMedicine
dc.subjectInternal Medicine Sciences
dc.subjectDermatology
dc.subjectNeurology
dc.subjectHealth Sciences
dc.subjectKlinik Tıp (MED)
dc.subjectKlinik Tıp
dc.subjectPsikiyatri
dc.subjectDERMATOLOJİ
dc.subjectKLİNİK NÖROLOJİ
dc.subjectClinical Medicine (MED)
dc.subjectCLINICAL MEDICINE
dc.subjectPSYCHIATRY
dc.subjectDERMATOLOGY
dc.subjectCLINICAL NEUROLOGY
dc.subjectNöroloji (klinik)
dc.subjectPsikiyatri ve Ruh Sağlığı
dc.subjectNeurology (clinical)
dc.subjectPsychiatry and Mental Health
dc.subjectComparative effectiveness
dc.subjectFingolimod
dc.subjectHigh-efficacy treatment
dc.subjectMultiple sclerosis
dc.subjectNatalizumab
dc.subjectOcrelizumab
dc.titleThe comparative effectiveness of fingolimod, natalizumab, and ocrelizumab in relapsing-remitting multiple sclerosis
dc.typearticle
dspace.entity.typePublication
local.avesis.id00f4e8df-769f-4b00-8cc3-69569fa40f16
local.indexed.atPUBMED
local.indexed.atSCOPUS
relation.isAuthorOfPublication2cdba045-abf1-46b3-ba7f-6b06308d9e57
relation.isAuthorOfPublication.latestForDiscovery2cdba045-abf1-46b3-ba7f-6b06308d9e57

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