The power of data; moving mountains and liberating people with MS. #ClinicSpeak #MSBlog #MSResearch
"Better the devil you know that the devil you don't. I have been telling my patients who are stable on an injectable that as they are responding to a particular class of DMT do they really want to take a chance and switch to an oral a new class of DMT when we have no idea if they will respond to or not?"
"I have been saying that if you are currently a responder (NEDA-3) to IFNbeta or glatiramer acetate we have no idea if you will respond to DMF (dimethyl fumarate, Tecfidera) or teriflunomide (Aubagio). As these drugs have different modes of action I have no idea if response to one drug predicts response to another drug. The good news is that it appears I was wrong. The study below using real-life data from MSBase shows that pwMS stable on IFNbeta or GA have no increased relapse rate when they switch to an oral. Good news? Yes, very good news. I know a large number of patients who are simply tired of injecting themselves who will now want to make the switch. It shows you the power of data. Data can move mountains."
"Congratulations to the MSBase team for another wonderful publication. You are really making a difference to the way we practice clinical neurology. I am sure a lot of pwMS will be thankful for your efforts; particularly this study. Prof G can't sit on the fence anymore."
BACKGROUND AND PURPOSE: Early relapse outcomes in long-term stable patients switching from interferon β/glatiramer acetate (IFNβ/GA) to oral therapy are unknown.
OBJECTIVE: The objective of this study was to compare early relapse and progression in multiple sclerosis (MS) patients switching to oral therapy following a period of stable disease on IFNβ/GA, relative to a propensity-matched comparator of patients remaining on IFNβ/GA.
METHODS: The MSBase cohort study is a global, longitudinal registry for MS. Time to first 6-month relapse in previously stable MS patients switching from platform injectables ('switchers') to oral agents were compared with propensity-matched patients remaining on IFNβ/GA ('stayers') using a Cox marginal model.
RESULTS: Three-hundred and ninety-six switchers were successfully matched to 396 stayers on a 1:1 basis. There was no difference in the proportion of patients recording at least one relapse in the first 1-6 months by treatment arm (7.3% switchers, 6.6% stayers; P = 0.675). The mean annualized relapse rate (P = 0.493) and the rate of first 6-month relapse by treatment arm (hazard ratio 1.22, 95% confidence interval 0.70, 2.11) were also comparable. There was no difference in the rate of disability progression by treatment arm (hazard ratio 1.43, 95% confidence interval 0.63, 3.26).
CONCLUSION: This is the first study to compare early relapse switch probability in the period immediately following switch to oral treatment in a population previously stable on injectable therapy. There was no evidence of disease reactivation within the first 6 months of switching to oral therapy.