Cladribine versus fingolimod, natalizumab and interferon β for multiple sclerosis

Kalincik, Tomas, Jokubaitis, Vilija, Spelman, Tim, Horakova, Dana, Havrdova, Eva, Trojano, Maria, Lechner-Scott, Jeannette, Lugaresi, Alessandra, Prat, Alexandre, Girard, Marc, Duquette, Pierre, Grammond, Pierre, Solaro, Claudio, Grand'Maison, Francois, Hupperts, Raymond, Prevost, Julie, Sola, Patrizia, Ferraro, Diana, Terzi, Murat, Butler, Ernest, Slee, Mark, Kermode, Allan, Fabis-Pedrini, Marzena, McCombe, Pamela, Barnett, Michael, Shaw, Cameron, Hodgkinson, Suzanne, Butzkueven, Helmut and MSBase Study Group (2017) Cladribine versus fingolimod, natalizumab and interferon β for multiple sclerosis. Multiple Sclerosis (Houndmills, Basingstoke, England), 1352458517728812. doi:10.1177/1352458517728812

Author Kalincik, Tomas
Jokubaitis, Vilija
Spelman, Tim
Horakova, Dana
Havrdova, Eva
Trojano, Maria
Lechner-Scott, Jeannette
Lugaresi, Alessandra
Prat, Alexandre
Girard, Marc
Duquette, Pierre
Grammond, Pierre
Solaro, Claudio
Grand'Maison, Francois
Hupperts, Raymond
Prevost, Julie
Sola, Patrizia
Ferraro, Diana
Terzi, Murat
Butler, Ernest
Slee, Mark
Kermode, Allan
Fabis-Pedrini, Marzena
McCombe, Pamela
Barnett, Michael
Shaw, Cameron
Hodgkinson, Suzanne
Butzkueven, Helmut
MSBase Study Group
Title Cladribine versus fingolimod, natalizumab and interferon β for multiple sclerosis
Journal name Multiple Sclerosis (Houndmills, Basingstoke, England)   Check publisher's open access policy
ISSN 1477-0970
Publication date 2017-08-31
Year available 2017
Sub-type Article (original research)
DOI 10.1177/1352458517728812
Open Access Status DOI
Start page 1352458517728812
Total pages 10
Place of publication London, United Kingdom
Publisher Sage Publications
Language eng
Subject 2808 Neurology
2728 Clinical Neurology
Abstract This propensity score-matched analysis from MSBase compared the effectiveness of cladribine with interferon β, fingolimod or natalizumab.

We identified all patients with relapse-onset multiple sclerosis, exposure to the study therapies and ⩾1-year on-treatment follow-up from MSBase. Three pairwise propensity score-matched analyses compared treatment outcomes over 1 year. The outcomes were hazards of first relapse, disability accumulation and disability improvement events. Sensitivity analyses were completed.

The cohorts consisted of 37 (cladribine), 1940 (interferon), 1892 (fingolimod) and 1410 patients (natalizumab). The probability of experiencing a relapse on cladribine was lower than on interferon ( p = 0.05), similar to fingolimod ( p = 0.31) and higher than on natalizumab ( p = 0.042). The probability of disability accumulation on cladribine was similar to interferon ( p = 0.37) and fingolimod ( p = 0.089) but greater than natalizumab ( p = 0.021). The probability of disability improvement was higher on cladribine than interferon ( p = 0.00017), fingolimod ( p = 0.0025) or natalizumab ( p = 0.00099). Sensitivity analyses largely confirmed the above results.

Cladribine is an effective therapy for relapse-onset multiple sclerosis. Its effect on relapses is comparable to fingolimod and its effect on disability accrual is comparable to interferon β and fingolimod. Cladribine may potentially associate with superior recovery from disability relative to interferon, fingolimod and natalizumab.
Keyword Cladribine
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
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Created: Wed, 29 Nov 2017, 12:23:40 EST