Clinical predictors of Dimethyl Fumarate response in multiple sclerosis: a real life multicentre study

2020 ◽  
Vol 38 ◽  
pp. 101871 ◽  
Author(s):  
R. Lanzillo ◽  
M. Moccia ◽  
R. Palladino ◽  
E. Signoriello ◽  
A. Carotenuto ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Multicentre Study ◽  
Real Life ◽  
Dimethyl Fumarate ◽  
Clinical Predictors

scholarly journals Comparative effectiveness of dimethyl fumarate in Multiple Sclerosis

2021 ◽  
Author(s):  
Pauline Bosco-Levy ◽  
Marc Debouverie ◽  
Bruno Brochet ◽  
Céline Louapre ◽  
Elisabeth Maillard ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Negative Binomial ◽  
Real Life ◽  
Logistic Models ◽  
Negative Binomial Regression ◽  
Dimethyl Fumarate ◽  
Population Based ◽  
Disability Progression ◽  
Real Life Setting ◽  
Using Data

Abstract Objectives: To assess the effectiveness of dimethyl fumarate (DMF) on annual rate of relapse (ARR) and disability progression in multiple sclerosis (MS) compared to injectable immunomodulators (IMM), teriflunomide (TERI) and fingolimob (FTY), in real life setting. Methods: A population-based cohort study was conducted using data of the French nationwide claims database, SNDS. All patients initiating IMM, TERI, FTY or DMF between July 1, 2015 and December 12, 2017, with 4.5 years of database history and 1 to 3.5 years of follow-up were included in this study. DMF patients were 1:1 matched to IMM, TERI or FTY using a high dimensional Propensity Score. Negative binomial regression and a regression logistic models were used to estimate the relative risk (RR ± [95% CI]) of ARR and the Odds Ratio (OR ± [95% CI]) of disability progression, respectively. Results: Overall, 9 304 subjects were identified: 29.0% initiated DMF, 33.2% TERI, 5.6% FTY and 32.2% an IMM. The matched cohorts consisted of 1779 DMF- IMM, patients, 1679 DMF-TERI patients, and 376 DMF-FTY patients. DMF significantly reduced ARR compared to IMM (RR 0.72 [0.61 - 0.86]) and TERI (0.81 [0.68 - 0.96]). The risk of the progression of MS specific disability was not significantly different for any matched cohorts.Interpretation: DMF is associated with lower risk of relapse for patients with RRMS than other first-line RRMS agents (TERI and IIM).

scholarly journals Comparative effectiveness of dimethyl fumarate in Multiple Sclerosis

2021 ◽  
Author(s):  
Pauline Bosco-Lévy ◽  
Marc Debouverie ◽  
Bruno Brochet ◽  
Francis Guillemin ◽  
Céline Louapre ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Negative Binomial ◽  
Real Life ◽  
Negative Binomial Regression ◽  
Dimethyl Fumarate ◽  
Population Based ◽  
Disability Progression ◽  
Logistic Regression Models ◽  
Significant Difference ◽  
Using Data

Objectives: To assess the effectiveness of dimethyl fumarate (DMF) on annual rate of relapse (ARR) and disability progression in multiple sclerosis (MS) compared to injectable immunomodulators (IMM), teriflunomide (TERI) and fingolimob (FTY), in real life setting. Methods: A population-based cohort study was conducted using data of the French nationwide claims database, SNDS. All patients initiating IMM, TERI, FTY or DMF between July 1, 2015 and December 12, 2017, with 4.5 years of database history and 1 to 3.5 years of follow-up were included in this study. DMF patients were 1:1 matched to IMM, TERI or FTY using a high dimensional Propensity Score. Negative binomial regression and a logistic regression models were used to estimate the relative risk (RR ± [95% CI]) of ARR and the Odds Ratio (OR ± [95% CI]) of disability progression, respectively. Results: Overall, 9 304 subjects were identified: 29.0% initiated DMF, 33.2% TERI, 5.6% FTY and 32.2% an IMM. The matched cohorts consisted of 1779 DMF- IMM, patients, 1679 DMF-TERI patients, and 376 DMF-FTY patients. DMF significantly reduced ARR compared to IMM (RR 0.72 [0.61 - 0.86]) and TERI (0.81 [0.68 - 0.96]) and did not show any significant difference when compared with FTY The risk of the progression of MS specific disability was not significantly different for any matched cohorts. Interpretation: DMF is associated with lower risk of relapse for patients with RRMS than other first-line RRMS agents (TERI and IIM).

scholarly journals Determinants of therapy switch in multiple sclerosis treatment-naïve patients: A real-life study

2018 ◽  
Vol 25 (9) ◽  
pp. 1263-1272 ◽  
Author(s):  
Francesco Saccà ◽  
Roberta Lanzillo ◽  
Alessio Signori ◽  
Giorgia T Maniscalco ◽  
Elisabetta Signoriello ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Real Life ◽  
Dimethyl Fumarate ◽  
Diagnosis Delay ◽  
Life Study ◽  
First Line Therapy ◽  
Therapy Choice ◽  
Treatment Naïve ◽  
Magnetic Resonance Imaging Mri ◽  
Cox Analysis

Background: With many options now available, first therapy choice is challenging in multiple sclerosis (MS) and depends mainly on neurologist and patient preferences. Objectives: To identify prognostic factors for early switch after first therapy choice. Methods: Newly diagnosed relapsing–remitting MS patients from 24 Italian centers were included. We evaluated the association of baseline demographics, clinical, and magnetic resonance imaging (MRI) data to the switch probability for lack of efficacy or intolerance/safety with a multivariate Cox analysis and estimated switch rates by competing risks models. Results: We enrolled 3025 patients. The overall switch frequency was 48% after 3 years. Switch risk for lack of efficacy was lower with fingolimod (hazard ratio (HR) = 0.50; p = 0.009), natalizumab (HR = 0.13; p < 0.001), dimethyl-fumarate (HR = 0.60; p = 0.037), teriflunomide (HR = 0.21; p = 0.031) as compared to interferons. Younger age (HR = 0.96; p < 0.001), diagnosis delay (HR = 1.23; p = 0.021), higher baseline Expanded Disability Status Scale (HR = 1.17; p = 0.001), and spinal cord lesions (HR = 1.46; p = 0.001) were independently associated with higher inefficacy switch rates. We found lower switch for intolerance/safety with glatiramer acetate (HR = 0.61; p = 0.001), fingolimod (HR = 0.35; p = 0.002), and dimethyl-fumarate (HR = 0.57; p = 0.022) as compared to interferons, while it increased with natalizumab (HR = 1.43; p = 0.022). Comorbidities were associated with intolerance switch (HR = 1.28; p = 0.047). Conclusion: Several factors are associated with higher switch risk in patients starting a first-line therapy and could be integrated in the decision-making process of first treatment choice.

Two-year real-life efficacy, tolerability and safety of dimethyl fumarate in an Italian multicentre study

2018 ◽  
Vol 265 (8) ◽  
pp. 1850-1859 ◽  
Author(s):  
Giulia Mallucci ◽  
P. Annovazzi ◽  
S. Miante ◽  
V. Torri-Clerici ◽  
M. Matta ◽  
...  
Keyword(s):  
Multicentre Study ◽  
Real Life ◽  
Dimethyl Fumarate
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