Contributions
Abstract: P686
Type: Poster
Abstract Category: Therapy - disease modifying - Long-term treatment monitoring
Background: Fingolimod has been approved for use within Scotland since April 2013 for highly active relapsing remitting multiple sclerosis (RRMS). Its use is restricted to patients failing first line therapy, beta-interferon/glatiramer acetate (BIFN/GA) or switching from natalizumab due to concerns about risks or side effects. Data on its effectiveness in real world practice is needed.
Objectives: To evaluate real world effects of fingolimod on annualised relapse rates (ARR), proportion relapse free and MRI disease progression in patients failing first line disease modifying therapies (DMTs) and switching from natalizumab.
Design and methods: A retrospective review of electronic medical records and MRI was undertaken in all fingolimod patients within the GMSC (n=93). Patients were identified using prescription records. The cohort was split into 3 groups: (A) switchers from BIFN/GA (n=56), (B) switchers from natalizumab (n=24) and (C) other circumstances, for example, those starting fingolimod after treatment interruption.
Results: 78.5% of patients remained relapse free (A:78.6%, B:79.2%) after a mean (95% CI) treatment duration of 407 days (354-459) (TRANSFORMS (360 days) 82.5% and FREEDOMS (720 days) 70.4%). The ARR for all fingolimod patients was 0.27 (0.12-0.42), which did not differ significantly between group A and B.
Of the 93 patients studied, 86 had a pre-fingolimod MRI, on average 279 days (193-365) prior to fingolimod. The first follow up MRI was after an average of 329 days (268-390) (n=63) and showed: 58.7% without increased T2 lesion load and/or GAD+ lesions, 34.9% with new T2 lesions and 6.4% with GAD+ lesions. TRANSFORMS showed: 54.8% without increased T2 lesion load and/or GAD+ lesions, 35.3% with new T2 lesions and 9.9% with GAD+ lesions over a similar time period.
Conclusion: The clinical and radiologic efficacy of fingolimod mirrored the findings from the pivotal trials in a real world cohort switching from both first line therapies and natalizumab.
Disclosure:
Kieran Fitzpatrick: Nothing to disclose
Sheena Murdoch: Nothing to disclose
Natasha Fullerton: Nothing to disclose
James Overell: Nothing to disclose
Stewart Webb: Nothing to disclose
Lesley Murray: Nothing to disclose
Abstract: P686
Type: Poster
Abstract Category: Therapy - disease modifying - Long-term treatment monitoring
Background: Fingolimod has been approved for use within Scotland since April 2013 for highly active relapsing remitting multiple sclerosis (RRMS). Its use is restricted to patients failing first line therapy, beta-interferon/glatiramer acetate (BIFN/GA) or switching from natalizumab due to concerns about risks or side effects. Data on its effectiveness in real world practice is needed.
Objectives: To evaluate real world effects of fingolimod on annualised relapse rates (ARR), proportion relapse free and MRI disease progression in patients failing first line disease modifying therapies (DMTs) and switching from natalizumab.
Design and methods: A retrospective review of electronic medical records and MRI was undertaken in all fingolimod patients within the GMSC (n=93). Patients were identified using prescription records. The cohort was split into 3 groups: (A) switchers from BIFN/GA (n=56), (B) switchers from natalizumab (n=24) and (C) other circumstances, for example, those starting fingolimod after treatment interruption.
Results: 78.5% of patients remained relapse free (A:78.6%, B:79.2%) after a mean (95% CI) treatment duration of 407 days (354-459) (TRANSFORMS (360 days) 82.5% and FREEDOMS (720 days) 70.4%). The ARR for all fingolimod patients was 0.27 (0.12-0.42), which did not differ significantly between group A and B.
Of the 93 patients studied, 86 had a pre-fingolimod MRI, on average 279 days (193-365) prior to fingolimod. The first follow up MRI was after an average of 329 days (268-390) (n=63) and showed: 58.7% without increased T2 lesion load and/or GAD+ lesions, 34.9% with new T2 lesions and 6.4% with GAD+ lesions. TRANSFORMS showed: 54.8% without increased T2 lesion load and/or GAD+ lesions, 35.3% with new T2 lesions and 9.9% with GAD+ lesions over a similar time period.
Conclusion: The clinical and radiologic efficacy of fingolimod mirrored the findings from the pivotal trials in a real world cohort switching from both first line therapies and natalizumab.
Disclosure:
Kieran Fitzpatrick: Nothing to disclose
Sheena Murdoch: Nothing to disclose
Natasha Fullerton: Nothing to disclose
James Overell: Nothing to disclose
Stewart Webb: Nothing to disclose
Lesley Murray: Nothing to disclose