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dc.contributor.authorKalincik, Tomas
dc.contributor.authorHorakova, Dana
dc.contributor.authorSpelman, Tim
dc.contributor.authorJokubaitis, Vilija
dc.contributor.authorTrojano, Maria
dc.contributor.authorLugaresi, Alessandra
dc.contributor.authorBergamaschi, Roberto
dc.date.accessioned2020-06-21T13:47:50Z
dc.date.available2020-06-21T13:47:50Z
dc.date.issued2015
dc.identifier.issn0364-5134
dc.identifier.issn1531-8249
dc.identifier.urihttps://doi.org/10.1002/ana.24339
dc.identifier.urihttps://hdl.handle.net/20.500.12712/14488
dc.descriptionOreja-Guevara, Celia/0000-0002-9221-5716; McCombe, Pamela/0000-0003-2704-8517; Horakova, Dana/0000-0003-1915-0036; Slee, Mark/0000-0003-4323-2453; Lugaresi, Alessandra/0000-0003-2902-5589; Jokubaitis, Vilija G./0000-0002-3942-4340; Havrdova, Eva Kubala/0000-0002-9543-4359; pucci, eugenio/0000-0001-7606-7330; Kalincik, Tomas/0000-0003-3778-1376; Trojano, Maria/0000-0002-6329-8946; Butzkueven, Helmut/0000-0003-3940-8727; Hodgkinson, Suzanne/0000-0002-9029-6663en_US
dc.descriptionWOS: 000350456800007en_US
dc.descriptionPubMed: 25546031en_US
dc.description.abstractObjectiveIn patients suffering multiple sclerosis activity despite treatment with interferon or glatiramer acetate, clinicians often switch therapy to either natalizumab or fingolimod. However, no studies have directly compared the outcomes of switching to either of these agents. MethodsUsing MSBase, a large international, observational, prospectively acquired cohort study, we identified patients with relapsing-remitting multiple sclerosis experiencing relapses or disability progression within the 6 months immediately preceding switch to either natalizumab or fingolimod. Quasi-randomization with propensity score-based matching was used to select subpopulations with comparable baseline characteristics. Relapse and disability outcomes were compared in paired, pairwise-censored analyses. ResultsOf the 792 included patients, 578 patients were matched (natalizumab, n=407; fingolimod, n=171). Mean on-study follow-up was 12 months. The annualized relapse rates decreased from 1.5 to 0.2 on natalizumab and from 1.3 to 0.4 on fingolimod, with 50% relative postswitch difference in relapse hazard (p=0.002). A 2.8 times higher rate of sustained disability regression was observed after the switch to natalizumab in comparison to fingolimod (p<0.001). No difference in the rate of sustained disability progression events was observed between the groups. The change in overall disability burden (quantified as area under the disability-time curve) differed between natalizumab and fingolimod (-0.12 vs 0.04 per year, respectively, p<0.001). InterpretationThis study suggests that in active multiple sclerosis during treatment with injectable disease-modifying therapies, switching to natalizumab is more effective than switching to fingolimod in reducing relapse rate and short-term disability burden. Ann Neurol 2015;77:425-435en_US
dc.description.sponsorshipMultiple Sclerosis Research Australia Postdoctoral Fellowship [11-054]; National Health and Medical Research Council (NHMRC) Early Career FellowshipNational Health and Medical Research Council of Australia [1071124]; NHMRC Career Development AwardNational Health and Medical Research Council of Australia [628856]; NHMRCNational Health and Medical Research Council of Australia [1032484]; NHMRC Centre for Research ExcellenceNational Health and Medical Research Council of Australia [1001216]; MSBase Foundation; Merck SeronoMerck SeronoMerck & Company; Biogen IdecBiogen; Novartis Pharma; Bayer ScheringBayer AG; Sanofi-AventisSanofi-Aventis; BioCSL; Charles University in Prague Project Grant [PRVOUK-P26/LF1/4]; Czech Ministry of Health Project Grant [NT13237-4/2012]en_US
dc.description.sponsorshipThis work was supported by the Multiple Sclerosis Research Australia Postdoctoral Fellowship (11-054, to T.K.), National Health and Medical Research Council (NHMRC) Early Career Fellowship (1071124, to T.K.), NHMRC Career Development Award (628856, to H.B.), NHMRC Project Grant (1032484, to H.B.), NHMRC Centre for Research Excellence (1001216, to H.B.), and MSBase Foundation. The MSBase Foundation is a not-for-profit organization that receives support from Merck Serono, Biogen Idec, Novartis Pharma, Bayer Schering, Sanofi-Aventis, and BioCSL. D.H. and E.H. are recipients of the Charles University in Prague Project Grant (PRVOUK-P26/LF1/4) and Czech Ministry of Health Project Grant (NT13237-4/2012).en_US
dc.language.isoengen_US
dc.publisherWileyen_US
dc.relation.isversionof10.1002/ana.24339en_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.titleSwitch to Natalizumab versus Fingolimod in Active Relapsing-Remitting Multiple Sclerosisen_US
dc.typearticleen_US
dc.contributor.departmentOMÜen_US
dc.identifier.volume77en_US
dc.identifier.issue3en_US
dc.identifier.startpage425en_US
dc.identifier.endpage435en_US
dc.relation.journalAnnals of Neurologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US


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