Lower Relapse Risk and Disability Progression With Oral DMT in Treatment-Naive RRMS
Initiation on an oral disease-modifying therapy was associated with a significantly greater likelihood of being free of confirmed disability progression at 1-year follow-up.
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In patients with relapse-remitting multiple sclerosis (RRMS), the initiation of oral disease-modifying therapy is associated with a lower relapse risk as well as a lower risk for disability progression compared with platform injectables, according to a study presented at the 34th Congress of the European Committee for Treatment and Research in Multiple Sclerosis meeting, held October 10 to 12, 2018, in Berlin, Germany.
"In Switzerland fingolimod, dimethyl fumarate and teriflunomide are licensed as first-line oral disease-modifying drugs," the researchers wrote. "For over 60% of the patients, drug reimbursement is bound to a standardized baseline and eventual annual documentation. This offers a unique opportunity to compare clinical outcomes of treatment-naive RRMS patients initiating oral drugs vs platform injectables (interferon-beta or glatiramer acetate)."
The Swiss MS treatment registry was used to obtain outcomes data on patients with MS who were treated with a first-line DMT between 1995 and 2017. A total of 2293 treatment-naive patients with RRMS who were treated with an oral disease-modifying therapy (n=1288) or platform injectable (n=1005) and who had data available at 1-year follow-up were included. Propensity-score matching was performed in a 1:1 ratio to compare clinical outcomes between groups. The primary outcomes were time to relapse and 12-month confirmed disability progression.
During a mean follow-up of 2.5 years (interquartile range, 1.5-5.0 years), patients with RRMS who had started an oral disease-modifying therapy were significantly more likely to be relapse-free compared with those receiving a platform injectable (hazard ratio, 0.67; 95% CI, 0.56-0.79; P <.001). In addition, initiation on an oral disease-modifying therapy was associated with a significantly greater likelihood of being free of confirmed disability progression at 1-year follow-up (hazard ratio, 0.60; 95% CI, 0.41-0.88; P =.008). According to the researchers, sensitivity analyses confirmed these findings.
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Benkert BP, Basel CH. Oral drugs versus interferon-beta or glatiramer acetate as first-line disease modifying therapy in relapsing-remitting multiple sclerosis. Presented at: 34th Congress of the European Committee for Treatment and Research in Multiple Sclerosis; October 10-12, 2018; Berlin, Germany. Abstract P1208.