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

Massimiliano Mirabella, Matteo Lucchini, Emanuele D’Amico, Aurora Zanghì, Mariangela Sciandra, Roberta Lanzillo, Graziella Callari, Antonio Cortese, Giacomo Lus, Maria Buccafusca, Simona Bonavita, Antonio Gallo, Erica Curti, Alberto Gajofatto, Elisabetta Signoriello, Alvino Bisecco, Francesca Gobbin, Maria Teresa Ferrò, Gina Ferrazzano, Maddalena SparacoPaola Valentino, 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

Risultato della ricerca: Contributo in rivistaArticolo in rivistapeer review

6 Citazioni (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.
Lingua originaleEnglish
pagine (da-a)3008-3020
Numero di pagine13
RivistaJournal of Neurology
Volume267
DOI
Stato di pubblicazionePubblicato - 2020

Keywords

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

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