Comparison of fingolimod, dimethyl fumarate and teriflunomide for multiple sclerosis

Tomáš Kalinčík ,Diana Ferraro,Vilija Jokubaitis,Ernest Butler,Julie Prevost,Steve Vucic,Radek Ampapa,Recai Türkoğlu ,Marc Girard,Serkan Özakbaş ,José Luis Sánchez Menoyo ,Suzanne Hodgkinson,Jeannette Lechner‐Scott ,Mark Slee,María Trojano ,Cavit Boz,Jens Kuhle,Guillermo Izquierdo,Pierre Grammond,Pamela Mccombe ,Tim Spelman,Roberto Bergamaschi,Dana Horáková ,Murat Terzı ,Alessandra Lugaresi,Eva Havrdová ,Cristina Ramo-Tello,Pierre Duquette,Franco Granella,Patrizia Sola,François Grand’maison ,Vincent Van Pesch,Daniele Spitaleri,Rana Karabudak,Ludwig Kappos,Bassem Yamout,Eugenio Pucci,Claudio Solaro,Alexandre Prat,Marco Onofrj,Bart Van Wijmeersch,Vahid Shaygannejad,Raed Alroughani,Helmut Butzkueven

doi:10.1136/jnnp-2018-319831

Abstract

ObjectiveOral immunotherapies have become a standard treatment in relapsing-remitting multiple sclerosis. Direct comparison of their effect on relapse and disability is needed.MethodsWe identified all patients with relapsing-remitting multiple sclerosis treated...

Highlights

Oral immunotherapies have changed the standard of managing relapsing-remitting multiple sclerosis (MS) and prescription practices globally.[1]
While the proportions of patients with no evidence of disease activity were similar in those treated with fingolimod or dimethyl fumarate as their first treatment choice, fingolimod was superior to dimethyl fumarate among patients who switched to oral agents from injectable therapies.[11]
Patients treated with fingolimod tended to have higher Expanded Disability Status Scale (EDSS) and more relapses during the prior year in comparison to those treated with dimethyl fumarate

Summary

Introduction

Oral immunotherapies have changed the standard of managing relapsing-remitting multiple sclerosis (MS) and prescription practices globally.[1]. Their availability as a first-line treatment has led to their use as a default initial therapy in several countries. The recently published post hoc comparisons combining data from the pivotal placebo-controlled trials[6–9] and observational cohorts[10 11] suggested that fingolimod and dimethyl fumarate are comparable in suppressing episodic inflammatory activity. Results of these studies varied, most probably due to variability in patients’ underlying disease activity. While the proportions of patients with no evidence of disease activity were similar in those treated with fingolimod or dimethyl fumarate as their first treatment choice, fingolimod was superior to dimethyl fumarate among patients who switched to oral agents from injectable therapies.[11]

Methods

Results

Conclusion