Lateral switch to IFN beta-1a 44 mcg may be effective as escalation switch to fingolimod in selected persons with relapsing remitting multiple sclerosis: a real-world setting experience

ABSTRACT

Background: The efficacy of lateral and escalation switch is a challenge in MS. We compared in a real-world setting the efficacy of switching to IFN beta-1a 44 mcg or to fingolimod in persons with relapsing remitting MS (pwRRMS) who failed with others injectable IFNs or glatiramer acetate.

Research design and methods: retrospective analysis of 24 months prospectively-collected data at the MS center of the University of Catania, Italy was performed. Patients who were switched to IFN-beta 1a 44 mcg or fingolimod were analyzed using propensity-score covariate adjustment model within demographic (e.g. age and gender) and disease (e.g. timing of pre-switch relapse) characteristics. Switching-time was considered the starting-time of the observation.

Results: 43 pwRRMS on IFN beta-1a 44 mcg and 49 pwRRMS on fingolimod were included. Baseline characteristics differed for EDSS score and number of T2 lesions (higher in group on fingolimod). At 24 months of follow up, both groups showed no differences in the survival curves of reaching a first new relapse, new T2 and Gd+ MRI brain lesions, even corrected for the propensity score covariate adjustment.

Conclusions: lateral switch to IFN beta-1a 44 mcg and escalation switch to fingolimod showed same ability in influencing RRMS disease activity at 24 months.

KEYWORDS:

• Multiple sclerosis
• therapeutic failure
• IFN beta-1a 44 mcg
• fingolimod
• switch

Declaration of interest

E D’Amico has received honoraria as a speaker from Teva, Biogen, Merck Serono, Bayer Schering, Genzyme/Sanofi and Novartis. F Patti has served on scientific advisory boards for Teva, Biogen-Idec, Bayer-Schering and Novartis and has received honoraria as a speaker for Teva, Biogen, Merck Serono, Bayer-Schering, Genzyme/Sanofi and Novartis. SL Fermo has received honoraria as a speaker from Teva, Biogen, Merck Serono and Novartis. M Zappia has served on scientific advisory boards and received honoraria as a speaker from UCB-Union Chimique Belge and Lundbeck and has received scientific grants from the Italian Medicines Agency (AIFA) and Novartis. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This manuscript was not funded.