Discontinuation and comparative effectiveness of dimethyl fumarate and fingolimod in 2 centers

Neurology. Clinical Practice
Brandi VollmerCarrie M Hersh

Abstract

Dimethyl fumarate (DMF) and fingolimod (FTY) are approved oral disease-modifying therapies for relapsing multiple sclerosis (MS). Observational studies are valuable when randomized clinical trials cannot be done due to ethical or practical reasons. Two-site studies allow investigators to further ascertain external validity of previously examined treatment effect differences. Limited head-to-head 2-site studies exist comparing DMF and FTY. Patients prescribed DMF (n = 737) and FTY (n = 535) from 2 academic multiple sclerosis (MS) centers (Cleveland Clinic and University of Colorado) were identified. Discontinuation and disease activity endpoints were assessed using propensity score (PS) weighting. Covariates used in the PS model included demographics and clinical and MRI characteristics. PS weighting demonstrated excellent covariate balance. Discontinuation was more common in DMF (44.2%) compared to FTY (34.8%) over 24 months (odds ratio [OR] 1.55, 95% confidence interval [CI] 1.21-1.99, p < 0.001). The leading cause for discontinuation was intolerability for both DMF (56.1% of DMF discontinuations) and FTY (46.2% of FTY discontinuations) (OR 1.65, 95% CI 1.21-2.25, p = 0.002). The proportion of patients with clinical relapses w...Continue Reading

References

Apr 23, 2002·The Journal of Biological Chemistry·Volker BrinkmannKevin R Lynch
Jan 22, 2010·The New England Journal of Medicine·Ludwig KapposUNKNOWN FREEDOMS Study Group
Jan 22, 2010·The New England Journal of Medicine·Jeffrey A CohenUNKNOWN TRANSFORMS Study Group
Sep 1, 2011·Multiple Sclerosis : Clinical and Laboratory Research·Ludwig KapposGilmore N O'Neill
Sep 21, 2012·The New England Journal of Medicine·Robert J FoxUNKNOWN CONFIRM Study Investigators
Sep 21, 2012·The New England Journal of Medicine·Ralf GoldUNKNOWN DEFINE Study Investigators
Oct 22, 2013·Brain : a Journal of Neurology·Tomas KalincikUNKNOWN MSBase Study Group
Apr 9, 2015·The New England Journal of Medicine·Thorsten RosenkranzChristoph Terborg
Apr 24, 2015·Journal of Clinical Pharmacology·Damiano PaolicelliMaria Trojano
Jul 22, 2015·Multiple Sclerosis and Related Disorders·Gavin GiovannoniMonica Marta
Sep 9, 2016·Neurology. Neuroimmunology and Neuroinflammation·Moogeh BaharnooriJames M Stankiewicz
Dec 7, 2016·Multiple Sclerosis and Related Disorders·Carrie M HershDaniel Ontaneda
Feb 6, 2017·Multiple Sclerosis : Clinical and Laboratory Research·Ali ManouchehriniaJan Hillert
Aug 26, 2017·Multiple Sclerosis Journal - Experimental, Translational and Clinical·Brandi VollmerEnrique Alvarez
Sep 12, 2017·Multiple Sclerosis Journal - Experimental, Translational and Clinical·Carrie M HershDaniel Ontaneda

❮ Previous
Next ❯

Citations

Aug 9, 2019·Multiple Sclerosis : Clinical and Laboratory Research·Mathias GranqvistFredrik Piehl
Nov 5, 2019·Multiple Sclerosis : Clinical and Laboratory Research·Robert T NaismithRichard Leigh-Pemberton
Jan 16, 2020·Neurology. Neuroimmunology and Neuroinflammation·Lara DiemRobert Hoepner
Jun 6, 2020·Neurodegenerative Disease Management·Carrie M Hersh, Le H Hua
Jun 17, 2020·Expert Opinion on Pharmacotherapy·Cristina Valencia-Sanchez, Jonathan L Carter
Apr 4, 2019·Nature Reviews. Neurology·Dalia Rotstein, Xavier Montalban
Sep 26, 2020·Journal of Neurology·Johannes LorscheiderÖzgür Yaldizli
Jan 30, 2021·Neurology. Clinical Practice·Carrie M HershLe H Hua

❮ Previous
Next ❯

Software Mentioned

R
Excel
Redcap

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.