TY - JOUR
T1 - Dimethyl fumarate vs Teriflunomide: an Italian time-to-event data analysis
AU - D’Amico, Emanuele
AU - Zanghì, Aurora
AU - Sciandra, Mariangela
AU - Lanzillo, Roberta
AU - Callari, Graziella
AU - Cortese, Antonio
AU - Lus, Giacomo
AU - Lucchini, Matteo
AU - Buccafusca, Maria
AU - Bonavita, Simona
AU - Gallo, Antonio
AU - Curti, Erica
AU - Gajofatto, Alberto
AU - Signoriello, Elisabetta
AU - Bisecco, Alvino
AU - Gobbin, Francesca
AU - Ferrò, Maria Teresa
AU - Ferrazzano, Gina
AU - Sparaco, Maddalena
AU - Valentino, Paola
AU - Mirabella, Massimiliano
AU - Granella, Franco
AU - Bresciamorra, Vincenzo
AU - Grimaldi, Luigi Maria Edoardo
AU - Patti, Francesco
AU - Borriello, Giovanna
AU - Grossi, Paola
AU - Carotenuto, Antonio
AU - Siena, Ernesto
AU - Tsantes, Elena
AU - Giugno, Alessia
AU - Abbadessa, Gian Marco
AU - Chisari, Clara Grazia
PY - 2020
Y1 - 2020
N2 - 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.
AB - 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.
KW - Dimethyl fumarate
KW - Efficacy
KW - Multiple sclerosis
KW - Safety
KW - Teriflunomide
KW - Dimethyl fumarate
KW - Efficacy
KW - Multiple sclerosis
KW - Safety
KW - Teriflunomide
UR - http://hdl.handle.net/10807/165295
U2 - 10.1007/s00415-020-09959-1
DO - 10.1007/s00415-020-09959-1
M3 - Article
SN - 0340-5354
VL - 267
SP - 3008
EP - 3020
JO - Journal of Neurology
JF - Journal of Neurology
ER -