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Comparative effectiveness of dimethyl fumarate as the initial and secondary treatment for MS.
- Source :
- Multiple Sclerosis Journal; Oct2020, Vol. 26 Issue 12, p1532-1539, 8p
- Publication Year :
- 2020
-
Abstract
- Background: Population-based real-world evidence studies of the effectiveness and tolerability of dimethyl fumarate in relation to common treatment alternatives are still limited. Objective: To evaluate the clinical effectiveness and tolerability of dimethyl fumarate (DMF) as the initial and secondary treatment for relapsing-remitting multiple sclerosis (RRMS) patients compared with common treatment alternatives in Sweden. Methods: We conducted a nationwide retrospective observational cohort study of all RRMS patients identified through the Swedish MS registry initiating DMF (n = 641) or interferons/glatiramer acetate (IFN/GA; n = 555) as the initial therapy, or DMF (n = 703) or fingolimod (FGL; n = 194) after switch from IFN/GA between 1 January 2014 and 31 December 2016. Results: The discontinuation rate was lower with DMF as the initial treatment than IFN/GA (adjusted hazard rate (HR): 0.46, 95% confidence interval (CI): 0.37–0.58, p < 0.001), but higher than FGL as the secondary treatment (HR: 1.51, CI: 1.08–2.09, p < 0.05). Annualized relapse rate (ARR) was lower with DMF compared to IFN/GA (0.04, CI: 0.03–0.06 vs 0.10, CI: 0.07–0.13; p < 0.05), but not FGL (0.03, CI: 0.02–0.05 vs 0.02, CI: 0.01–0.04; p = 0.41). Finally, time to first relapse (TTFR) was longer with DMF as the initial, but not secondary, therapy (p < 0.05 and p = 0.20, respectively). Conclusion: Our findings indicate that DMF performs better than IFN/GA as the initial treatment for RRMS. Compared to FGL, DMF displayed a lower tolerability, but largely similar effectiveness outcomes. [ABSTRACT FROM AUTHOR]
- Subjects :
- GLATIRAMER acetate
MULTIPLE sclerosis
INTERFERONS
CONFIDENCE intervals
Subjects
Details
- Language :
- English
- ISSN :
- 13524585
- Volume :
- 26
- Issue :
- 12
- Database :
- Complementary Index
- Journal :
- Multiple Sclerosis Journal
- Publication Type :
- Academic Journal
- Accession number :
- 146495769
- Full Text :
- https://doi.org/10.1177/1352458519866600