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

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dc.authoridDemirkiran, Meltem/0000-0002-4649-5315
dc.authoridSoysal, Aysun/0000-0002-1598-5944
dc.authoridOzakbas, Serkan/0000-0003-2140-4103
dc.authoridYetkin, Mehmet Fatih/0000-0002-2541-7107
dc.authoridTERZİ, Murat/0000-0002-3586-9115
dc.authoridBaba, Cavid/0000-0001-5455-7080
dc.authoridTürkoğlu, Recai/0000-0001-9724-851X
dc.authorwosidDemirkiran, Meltem/AGV-1689-2022
dc.authorwosidSoysal, Aysun/AAX-7696-2021
dc.authorwosidOzakbas, Serkan/V-6427-2019
dc.authorwosidYetkin, Mehmet Fatih/A-2173-2016
dc.authorwosidEFENDI, HÜSNÜ/JUU-8107-2023
dc.authorwosidSevim, Serhan/KBA-7417-2024
dc.authorwosidTERZİ, Murat/AAA-1284-2021
dc.contributor.authorBoz, Cavit
dc.contributor.authorOzakbas, Serkan
dc.contributor.authorTerzi, Murat
dc.contributor.authorKarabudak, Rana
dc.contributor.authorSevim, Serhan
dc.contributor.authorTurkoglu, Recai
dc.contributor.authorSoysal, Aysun
dc.date.accessioned2024-06-12T11:08:47Z
dc.date.available2024-06-12T11:08:47Z
dc.date.issued2023
dc.departmentTrakya Üniversitesien_US
dc.description.abstractBackgroundFingolimod, 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.ObjectivesThe objective of this study was to compare the efficacy of fingolimod, natalizumab, and ocrelizumab in reducing disease activity in RRMS.MethodsThis 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.ResultsPropensity 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.ConclusionNatalizumab 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.en_US
dc.identifier.doi10.1007/s10072-023-06608-z
dc.identifier.endpage2129en_US
dc.identifier.issn1590-1874
dc.identifier.issn1590-3478
dc.identifier.issue6en_US
dc.identifier.pmid36689010en_US
dc.identifier.scopus2-s2.0-85146757912en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage2121en_US
dc.identifier.urihttps://doi.org/10.1007/s10072-023-06608-z
dc.identifier.urihttps://hdl.handle.net/20.500.14551/22571
dc.identifier.volume44en_US
dc.identifier.wosWOS:000921721400005en_US
dc.identifier.wosqualityN/Aen_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherSpringer-Verlag Italia Srlen_US
dc.relation.ispartofNeurological Sciencesen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectMultiple Sclerosisen_US
dc.subjectComparative Effectivenessen_US
dc.subjectFingolimoden_US
dc.subjectNatalizumaben_US
dc.subjectOcrelizumaben_US
dc.subjectHigh-Efficacy Treatmenten_US
dc.subjectPlacebo-Controlled Trialen_US
dc.subjectDisease-Activityen_US
dc.subjectOral Fingolimoden_US
dc.subjectInterferonen_US
dc.subjectRituximaben_US
dc.titleThe comparative effectiveness of fingolimod, natalizumab, and ocrelizumab in relapsing-remitting multiple sclerosisen_US
dc.typeArticleen_US

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