Beyond First-Line: Natalizumab vs Fingolimod for Relapsing-Remitting Multiple Sclerosis

A Personal Decision

Ultimately, the patient and physician must decide mutually on the most appropriate treatment option and acceptable level of risk of PML. Patients with high disease activity and multiple indicators of poor prognosis, for example, may decide that a higher level of efficacy is worth an increased risk.  

Meanwhile, research continues to work towards facilitation of more precise personalization of treatment. Using data from the MSBase registry, Dr Kalincik and colleagues have been investigating the topic of individually tailored therapy, and they believe they “will soon be able to provide clinicians and their patients with some valuable supportive information concerning individual treatment choice,” he said.

References

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2. Kalincik T, Horakova D, Spelman T, et al. Switch to natalizumab versus fingolimod in active relapsing-remitting multiple sclerosis. Ann Neurol. 2015;77(3):425-35.
3. Cohen BA, Coyle PK, Leist T, Oleen-burkey MA, Schwartz M, Zwibel H. Therapy Optimization in Multiple Sclerosis: a cohort study of therapy adherence and risk of relapse. Mult Scler Relat Disord. 2015;4(1):75-82.
4. Coyle PK, Cohen BA, Leist T, et al. Therapy optimization in multiple sclerosis: a prospective observational study of therapy compliance and outcomes. BMC Neurol. 2014;14:49.
5. Leist TP, Comi G, Cree BA, et al. Effect of oral cladribine on time to conversion to clinically definite multiple sclerosis in patients with a first demyelinating event (ORACLE MS): a phase 3 randomised trial. Lancet Neurol. 2014; 13(3):257-67.