Abstract

ObjectiveTo evaluate the 5-year real-world benefit–risk profile of fingolimod in patients with relapsing–remitting MS (RRMS) in Germany.MethodsPost-Authorization Non-interventional German sAfety study of GilEnyA (PANGAEA) is a non-interventional real-world study to prospectively assess the effectiveness and safety of fingolimod in routine clinical practice in Germany. The follow-up period comprised 5 years. Patients were included if they had been diagnosed with RRMS and had been prescribed fingolimod as part of clinical routine. There were no exclusion criteria except the contraindications for fingolimod as defined in the European label. The effectiveness and safety analysis set comprised 4032 and 4067 RRMS patients, respectively.ResultsAt the time of the 5-year follow-up of PANGAEA, 66.57% of patients still continued fingolimod therapy. Annualized relapse rates decreased from baseline 1.5 ± 1.15 to 0.42 ± 0.734 at year 1 and 0.21 ± 0.483 at year 5, and the disability status remained stable, as demonstrated by the Expanded Disability Status Scale mean change from baseline (0.1 ± 2.51), the decrease of the Multiple Sclerosis Severity Score from 5.1 ± 2.59 at baseline to 3.9 ± 2.31 at the 60-months follow-up, and the percentage of patients with ‘no change’ in the Clinical Global Impression scale at the 60-months follow-up (78.11%). Adverse events (AE) occurring in 75.04% of patients were in line with the known safety profile of fingolimod and were mostly non-serious AE (33.62%) and non-serious adverse drug reactions (50.59%; serious AE 4.98%; serious ADR 10.82%).ConclusionsPANGAEA demonstrated the sustained beneficial effectiveness and safety of fingolimod in the long-term real-world treatment of patients with RRMS.

Highlights

  • Fingolimod (Gilenya, Novartis Pharma AG, Basel, Switzerland), an oral disease-modifying therapy (DMT) approved for relapsing–remitting multiple sclerosis (RRMS), has an extensive safety profile

  • We report the results of the 5-year follow-up of Post-Authorization Non-interventional German sAfety study of GilEnyA (PANGAEA), a non-interventional, long-term study to assess effectiveness and safety of fingolimod in 4000 relapsing–remitting MS (RRMS) patients treated under real-world-conditions in Germany

  • As a non-interventional real-world study, PANGAEA complements and expands the data obtained in randomized clinical trials (RCTs)

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Summary

Introduction

Fingolimod (Gilenya, Novartis Pharma AG, Basel, Switzerland), an oral disease-modifying therapy (DMT) approved for relapsing–remitting multiple sclerosis (RRMS), has an extensive safety profile. The large prospective, 5-year Post-Authorization Non-interventional German sAfety study of GilEnyA (fingolimod) PANGAEA was initiated in 2011 [9]. Both a 12-months interim analysis [10] and 36-months follow-up of PANGAEA [11] showed the sustained effectiveness and safety of fingolimod, as demonstrated by reduced annualized relapse rates (ARRs) and stable Expanded Disability Status Scale (EDSS) scores, and the consistency of the frequency and nature of adverse events and adverse drug reactions

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