RT Journal Article
SR Electronic
T1 Comparative efficacy of fingolimod vs natalizumab
JF Neurology
JO Neurology
FD Lippincott Williams & Wilkins
SP 771
OP 778
DO 10.1212/WNL.0000000000002395
VO 86
IS 8
A1 Laetitia Barbin
A1 Chloe Rousseau
A1 Natacha Jousset
A1 Romain Casey
A1 Marc Debouverie
A1 Sandra Vukusic
A1 Jerome De Sèze
A1 David Brassat
A1 Sandrine Wiertlewski
A1 Bruno Brochet
A1 Jean Pelletier
A1 Patrick Vermersch
A1 Gilles Edan
A1 Christine Lebrun-Frenay
A1 Pierre Clavelou
A1 Eric Thouvenot
A1 Jean-Philippe Camdessanché
A1 Ayman Tourbah
A1 Bruno Stankoff
A1 Abdullatif Al Khedr
A1 Philippe Cabre
A1 Caroline Papeix
A1 Eric Berger
A1 Olivier Heinzlef
A1 Thomas Debroucker
A1 Thibault Moreau
A1 Olivier Gout
A1 Bertrand Bourre
A1 Alain Créange
A1 Pierre Labauge
A1 Laurent Magy
A1 Gilles Defer
A1 Yohann Foucher
A1 David A. Laplaud
YR 2016
UL http://n.neurology.org/content/86/8/771.abstract
AB Objective: To compare natalizumab and fingolimod on both clinical and MRI outcomes in patients with relapsing-remitting multiple sclerosis (RRMS) from 27 multiple sclerosis centers participating in the French follow-up cohort Observatoire of Multiple Sclerosis.Methods: Patients with RRMS included in the study were aged from 18 to 65 years with an Expanded Disability Status Scale score of 0–5.5 and an available brain MRI performed within the year before treatment initiation. The data were collected for 326 patients treated with natalizumab and 303 with fingolimod. The statistical analysis was performed using 2 different methods: logistic regression and propensity scores (inverse probability treatment weighting).Results: The confounder-adjusted proportion of patients with at least one relapse within the first and second year of treatment was lower in natalizumab-treated patients compared to the fingolimod group (21.1% vs 30.4% at first year, p = 0.0092; and 30.9% vs 41.7% at second year, p = 0.0059) and supported the trend observed in nonadjusted analysis (21.2% vs 27.1% at 1 year, p = 0.0775). Such statistically significant associations were also observed for gadolinium (Gd)-enhancing lesions and new T2 lesions at both 1 year (Gd-enhancing lesions: 9.3% vs 29.8%, p < 0.0001; new T2 lesions: 10.6% vs 29.6%, p < 0.0001) and 2 years (Gd-enhancing lesions: 9.1% vs 22.1%, p = 0.0025; new T2 lesions: 16.9% vs 34.1%, p = 0.0010) post treatment initiation.Conclusion: Taken together, these results suggest the superiority of natalizumab over fingolimod to prevent relapses and new T2 and Gd-enhancing lesions at 1 and 2 years.Classification of evidence: This study provides Class IV evidence that for patients with RRMS, natalizumab decreases the proportion of patients with at least one relapse within the first year of treatment compared to fingolimod.EDSS=Expanded Disability Status Scale; Gd=gadolinium; IPTW=inverse probability of treatment weighting; JCV=JC virus; MS=multiple sclerosis; NS=not significant; OFSEP=Observatoire of Multiple Sclerosis; OR=odds ratio; PML=progressive multifocal leukoencephalopathy; RRMS=relapsing-remitting multiple sclerosis