A comparison of efficacy of subcutaneous interferon beta-1a 44 mu g, dimethyl fumarate and fingolimod in the real-life clinical practise - a multicenter observational study
Abstract
Introduction: Multiple sclerosis is a chronic inflammatory demyelinating and neurodegenerative disease affecting the CNS. Interferon (IFN) beta-1a 44 mu g, dimethyl fumarate (DMF) and fingolimod are established medications for the treatment of relapsing-remitting MS (RR MS).
The aim of the project (analysis from registry ReMuS) was a comparison of the efficacy of IFN beta-1a 44 mu g, DMF and fingolimod in patients with RR MS in real world evidence in the Czech Republic. This treatment was started within 90 days after relapse.
Patients and methods: A total of 279 patients with RR MS who experienced one relapse during the first line treatment (IFN beta-1a 22 mu g given 3x weekly, IFN beta-1a 30 mu g given 1x weekly, IFN beta-1b 250 mu g given each other day, teriflunomid 14 mg given daily, glatiramer acetate 20 mg given daily or glatiramer acetate given 40 mg given 3x weekly) and who were switched to the treatment with IFN beta-1a 44 mu g, DMF or fingolimod were included into the study. The observed parameters were annualized relapse rate (ARR), time to next relapse, proportion of relapse free patients and change in Expanded Disability Status Scale (EDSS) at 1-year after treatment.
Results: We found out significant improvement in observed outcomes during 1-year observation after treatment change in all particular medications. Comparison of IFN beta-1a 44 mu g group (83 patients) vs.
DMF or fingolimod group (196 patients) showed more significant improvement in observed parameters (ARR and change of EDSS) in DMF or fingolimod group. When we used propensity score matching method (83 patients from IFN beta-1a 44 mu g group vs. 83 patients from DMF or fingolimod group), the sustained improvement in observed parameters has persisted before and after change of treatment in both groups but no significant differences were observed between groups.
Conclusion: IFN beta-1a 44 mu g, DMF and fingolimod proved the effectivness in escalation of treatment in the selected group of patients in observed parameters - change of EDSS and time to next relapse).