Frahm, Niklas ORCID: 0000-0002-4655-774X, Fneish, Firas, Ellenberger, David, Flachenecker, Peter, Paul, Friedemann, Warnke, Clemens ORCID: 0000-0002-3510-9255, Kleinschnitz, Christoph ORCID: 0000-0002-1650-8875, Parciak, Tina, Krefting, Dagmar ORCID: 0000-0002-7238-5339, Hellwig, Kerstin, Haas, Judith, Rommer, Paulus S., Stahmann, Alexander and Zettl, Uwe K. (2022). Therapy Switches in Fingolimod-Treated Patients with Multiple Sclerosis: Long-Term Experience from the German MS Registry. Neurol. Ther., 11 (1). S. 319 - 337. LONDON: SPRINGER LONDON LTD. ISSN 2193-6536

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Abstract

Introductions Therapy switches in patients with multiple sclerosis (MS) receiving treatment with fingolimod occur frequently in clinical practice but are not well represented in real-world data. The aim of this study was to identify and characterize treatment switches and reveal sociodemographic/clinical changes over time in fingolimod-treated people with MS (PwMS). Methods Data on 2536 fingolimod-treated PwMS extracted from the German MS Registry during different time periods were analyzed (2010-2019). Results Overall, 28.3% of PwMS were treatment-naive before fingolimod initiation. Interferon beta (30.7%) was the most common pre-fingolimod treatment. Ocrelizumab (19.8%) was the most frequent subsequent treatment in the 944 patients on fingolimod who switched. Between 2010 and 2019, median disease duration at fingolimod initiation decreased from 8.5 to 7.1 years (p < 0.001), and patients taking fingolimod for >= 1 year after treatment initiation decreased from 89.6 to 80.5% (p < 0.001). Females (p < 0.001) and young patients (p = 0.003) showed a shorter time on fingolimod. The most frequent reason for switching was disease activity (relapse/MRI) despite treatment. The annualized relapse rate increased from 0.37 in patients on fingolimod to 0.47 after treatment cessation, decreasing to 0.19 after treatment with a subsequent disease-modifying drug (DMD) was initiated. Conclusion Treatment switches from fingolimod to subsequent DMDs currently occur after shorter treatment durations than 10 years ago, possibly due to the growing treatment spectrum. Planning adequate washout periods is essential and should be done on an individualized basis.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Frahm, NiklasUNSPECIFIEDorcid.org/0000-0002-4655-774XUNSPECIFIED
Fneish, FirasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ellenberger, DavidUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Flachenecker, PeterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Paul, FriedemannUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Warnke, ClemensUNSPECIFIEDorcid.org/0000-0002-3510-9255UNSPECIFIED
Kleinschnitz, ChristophUNSPECIFIEDorcid.org/0000-0002-1650-8875UNSPECIFIED
Parciak, TinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Krefting, DagmarUNSPECIFIEDorcid.org/0000-0002-7238-5339UNSPECIFIED
Hellwig, KerstinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Haas, JudithUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rommer, Paulus S.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Stahmann, AlexanderUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Zettl, Uwe K.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-692341
DOI: 10.1007/s40120-021-00320-w
Journal or Publication Title: Neurol. Ther.
Volume: 11
Number: 1
Page Range: S. 319 - 337
Date: 2022
Publisher: SPRINGER LONDON LTD
Place of Publication: LONDON
ISSN: 2193-6536
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
Clinical NeurologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/69234

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