Dimethyl fumarate vs Teriflunomide: an Italian time-to-event data analysis

Emanuele D’Amico, Aurora Zanghì, Mariangela Sciandra, Roberta Lanzillo, Graziella Callari, Antonio Cortese, Giacomo Lus, Matteo Lucchini, Maria Buccafusca, Simona Bonavita, Antonio Gallo, Erica Curti, Alberto Gajofatto, Elisabetta Signoriello, Alvino Bisecco, Francesca Gobbin, Maria Teresa Ferrò, Gina Ferrazzano, Maddalena Sparaco, Paola ValentinoMassimiliano Mirabella, Franco Granella, Vincenzo Bresciamorra, Luigi Maria Edoardo Grimaldi, Francesco Patti, Giovanna Borriello, Paola Grossi, Antonio Carotenuto, Ernesto Siena, Elena Tsantes, Alessia Giugno, Gian Marco Abbadessa, Clara Grazia Chisari

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)

Abstract

Background: The introduction of oral disease-modifying therapies (DMTs) for relapsing–remitting multiple sclerosis (RRMS) changed algorithms of RRMS treatment. Objectives: To compare the effectiveness of treatment with dimethyl fumarate (DMF) and teriflunomide (TRF) in a large multicentre Italian cohort of RRMS patients. Materials and Methods: Patients with RRMS who received treatment with DMF and TRF between January 1st, 2012 and December 31st, 2018 from twelve MS centers were identified. The events investigated were “time-to-first-relapse”, “time-to-Magnetic-Resonance-Imaging (MRI)-activity” and “time-to-disability-progression”. Results: 1445 patients were enrolled (1039 on DMF, 406 on TRF) and followed for a median of 34 months. Patients on TRF were older (43.5 ± 8.6 vs 38.8 ± 9.2 years), with a predominance of men and higher level of disability (p < 0.001 for all). Patients on DMF had a higher number of relapses and radiological activity (p <.05) at baseline. Time-varying Cox-model for the event “time-to-first relapse” revealed that no differences were found between the two groups in the first 38 months of treatment (HRt < 38DMF = 0.73, CI = 0.52 to 1.03, p = 0.079). When the time-on-therapy exceeds 38 months patients on DMF had an approximately 0.3 times lower relapse hazard risk than those who took TRF (HRt>38DMF = 3.83, CI = 1.11 to 13.23, p = 0.033). Both DMTs controlled similarly MRI activity and disability progression. Conclusions: Patients on DMF had higher relapse-free survival time than TRF group after the first 38 months ontherapy.
Original languageEnglish
Pages (from-to)3008-3020
Number of pages13
JournalJournal of Neurology
Volume267
DOIs
Publication statusPublished - 2020

Keywords

  • Dimethyl fumarate
  • Efficacy
  • Multiple sclerosis
  • Safety
  • Teriflunomide

Fingerprint

Dive into the research topics of 'Dimethyl fumarate vs Teriflunomide: an Italian time-to-event data analysis'. Together they form a unique fingerprint.

Cite this