First-ever treatment in multiple sclerosis - 12/02/21
, C. Pot, R. Du Pasquier, G. Le Goff, M. ThéaudinBienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
| pages | 7 |
| Iconographies | 2 |
| Vidéos | 0 |
| Autres | 0 |
Highlights |
• | Both fingolimod and dimethyl fumarate reduce significantly the risk of disease progression in early-treated treatment-naive patients. |
• | There seems to be a prescription bias towards fingolimod in more active patients. |
• | Highly active patients at baseline are at higher risk of disease progression. |
Abstract |
Background |
The current treated MS population is very different from that of patients in randomized clinical trials.
Objectives |
To study the long-term efficacy and tolerance of fingolimod (FTY) and dimethyl fumarate (DMF), both available as first-line treatment in early-treated treatment-naïve MS patients.
Methods |
Retrospective analysis of 75 patients from our prospective MS registry fulfilling the inclusion criteria: FTY or DMF as first-line treatment, treatment initiation within 36months of disease onset and treatment duration>12months.
Results |
Demographics and MRI characteristics at baseline were similar in both groups (FTY 55 patients, DMF 20), but patients on FTY had higher pretreatment clinical activity (P=0.008). Twenty-two percent of patients in the FTY group and 15% in the DMF group had highly active disease. At last follow-up (mean: 44.2, SD: 17.3months), the majority of the patients were still on treatment while 54.5% of FTY and 65% of DMF patients reached NEDA 3 status (P=0.444). Both treatments significantly decreased relapses and occurrence of new T1 Gd-enhancing lesions (P<0.001). The main reason for discontinuation was disease activity without severe side effects on either treatment.
Conclusions |
Our findings support efficacy and tolerance of both drugs in early-treated treatment-naive MS patients, arguing in favour of efficient early immunomodulation in MS patients. Both drugs significantly reduced the incidence of new relapses and Gd-enhancing lesions on treatment with FTY being more frequently prescribed than DMF, especially in patients with evidence of higher clinical disease activity.
Le texte complet de cet article est disponible en PDF.Keywords : Multiple sclerosis, Disease modifying treatment, Fingolimod, Dimethyl fumarate, Real-world study
Plan
Vol 177 - N° 1-2
P. 93-99 - janvier 2021 Retour au numéro
Article précédent
- Identification and measurement of cervical spinal cord atrophy in neuromyelitis optica spectrum disorders (NMOSD) and correlation with clinical characteristics and cervical spinal cord MRI data
- F. Lersy, V. Noblet, T. Willaume, N. Collongues, L. Kremer, M. Fleury, J. de Seze, S. Kremer
- Should we prevent thrombosis related to intravenous immunoglobulin infusions with systematic anticoagulant prophylaxis?
- R. Arcani, A.-M. Grapperon, G. Venton, P. Suchon, A. Verschueren, J. Bas, E. Salort-Campana, S. Attarian, E. Delmont
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’achat d’article à l’unité est indisponible à l’heure actuelle.
Déjà abonné à cette revue ?