Contributions
Abstract: P570
Type: Poster Sessions
Abstract Category: Therapy - Immunomodulation/Immunosuppression
Objectives: To compare the efficacy, frequencies and reasons for treatment interruption of fingolimod (FTY), dimethyl fumarate (DMF) or teriflunomide (TERI) in a nationwide observational cohort using prospectively collected data.
Materials and methods: Two cohorts of patients with relapsing-remitting multiple sclerosis (RRMS) starting treatment with fingolimod, dimethyl fumarate or teriflunomide documented in the Austrian MS Treatment Registry (AMSTR) since 2014 and either staying on therapy for at least 12 months (12m cohort) or having at least one follow-up visit (total cohort). The 12m cohort included 664 RRMS patients: 315 in the fingolimod, 232 in the DMF and 117 in the teriflunomide group. Multinomial propensity scores were used for inverse probability weighting to correct for the bias of this non-randomised registry study.
Results: Estimated mean annualized relapse rates (ARR) over 12 months were 0.21 for fingolimod, 0.20 for DMF and 0.19 for teriflunomide treatment, causing an Incidence Rate Ratio (IRR) of 1.01 for fingolimod versus DMF (p=0.96) and 0.92 for teriflunomide versus DMF (p=0.84). No differences were found regarding the probability for experiencing a relapse, EDSS change, EDSS progression and EDSS regression, except regarding less sustained EDSS progression for 12 weeks concerning DMF versus fingolimod (p=0.02). The hazard ratio for treatment interruption comparing fingolimod versus DMF was 1.03 (p=0.86) and 1.07 comparing teriflunomide versus DMF (p=0.77).
Conclusions: In the AMSTR, there was no difference concerning ARR, probability for a relapse, EDSS change, treatment interruption, EDSS progression or regression between oral DMTs, except regarding less sustained EDSS progression for 12 weeks concerning DMF versus fingolimod.
Disclosure: Michael Guger received support and honoraria for research, consultation, lectures and education from Almirall, Bayer, Biogen, Celgene, Genzyme, MedDay, Merck, Novartis, Octapharma, Roche, Sanofi Aventis, Shire and TEVA ratiopharm.
Christian Enzinger received funding for travel and speaker honoraria from Biogen, Bayer Schering, Merck Serono, Novartis, Roche, Shire, Genzyme and Teva Pharmaceutical Industries Ltd./sanofi-aventis, research support from Merck Serono, Biogen, and Teva Pharmaceutical Industries Ltd./sanofi-aventis and serving on scientific advisory boards for Bayer Schering, Biogen, Merck Serono, Novartis, Roche and Teva Pharmaceutical Industries Ltd./sanofi- Aventis.
Fritz Leutmezer has received funding for travel and speaker honoraria from Biogen, Bayer Schering Pharma, Merck Serono, Novartis, Genzyme, Santhera and Teva Pharmaceutical Industries Ltd./sanofi-aventis.
Jörg Kraus received consulting and/or research funding and/or educational support from Almirall, Bayer, Biogen, Celgene, MedDay, Medtronic, Merck, Novartis, Roche, Sanofi-Aventis, Shire, TEVA ratiopharm.
Stefan Kalcher declares that there is no conflict of interest.
Erich Kvas declares that there is no conflict of interest.
Thomas Berger has participated in meetings sponsored by and received honoraria (lectures, advisory boards, consultations) from pharmaceutical companies marketing treatments for multiple sclerosis: Almirall, Bayer, Biogen, Biologix, Bionorica, Genzyme, MedDay, Merck, Novartis, Octapharma, Roche, Sanofi/Genzyme, TG Pharmaceuticals, TEVA-ratiopharm and UCB. His institution has received financial support in the last 12 months by unrestricted research grants (Biogen, Bayer, Merck, Novartis, Sanofi/Genzyme, and TEVA ratiopharm) and for participation in clinical trials in multiple sclerosis sponsored by Alexion, Bayer, Biogen, Merck, Novartis, Octapharma, Roche, Sanofi/Genzyme, and TEVA.
Abstract: P570
Type: Poster Sessions
Abstract Category: Therapy - Immunomodulation/Immunosuppression
Objectives: To compare the efficacy, frequencies and reasons for treatment interruption of fingolimod (FTY), dimethyl fumarate (DMF) or teriflunomide (TERI) in a nationwide observational cohort using prospectively collected data.
Materials and methods: Two cohorts of patients with relapsing-remitting multiple sclerosis (RRMS) starting treatment with fingolimod, dimethyl fumarate or teriflunomide documented in the Austrian MS Treatment Registry (AMSTR) since 2014 and either staying on therapy for at least 12 months (12m cohort) or having at least one follow-up visit (total cohort). The 12m cohort included 664 RRMS patients: 315 in the fingolimod, 232 in the DMF and 117 in the teriflunomide group. Multinomial propensity scores were used for inverse probability weighting to correct for the bias of this non-randomised registry study.
Results: Estimated mean annualized relapse rates (ARR) over 12 months were 0.21 for fingolimod, 0.20 for DMF and 0.19 for teriflunomide treatment, causing an Incidence Rate Ratio (IRR) of 1.01 for fingolimod versus DMF (p=0.96) and 0.92 for teriflunomide versus DMF (p=0.84). No differences were found regarding the probability for experiencing a relapse, EDSS change, EDSS progression and EDSS regression, except regarding less sustained EDSS progression for 12 weeks concerning DMF versus fingolimod (p=0.02). The hazard ratio for treatment interruption comparing fingolimod versus DMF was 1.03 (p=0.86) and 1.07 comparing teriflunomide versus DMF (p=0.77).
Conclusions: In the AMSTR, there was no difference concerning ARR, probability for a relapse, EDSS change, treatment interruption, EDSS progression or regression between oral DMTs, except regarding less sustained EDSS progression for 12 weeks concerning DMF versus fingolimod.
Disclosure: Michael Guger received support and honoraria for research, consultation, lectures and education from Almirall, Bayer, Biogen, Celgene, Genzyme, MedDay, Merck, Novartis, Octapharma, Roche, Sanofi Aventis, Shire and TEVA ratiopharm.
Christian Enzinger received funding for travel and speaker honoraria from Biogen, Bayer Schering, Merck Serono, Novartis, Roche, Shire, Genzyme and Teva Pharmaceutical Industries Ltd./sanofi-aventis, research support from Merck Serono, Biogen, and Teva Pharmaceutical Industries Ltd./sanofi-aventis and serving on scientific advisory boards for Bayer Schering, Biogen, Merck Serono, Novartis, Roche and Teva Pharmaceutical Industries Ltd./sanofi- Aventis.
Fritz Leutmezer has received funding for travel and speaker honoraria from Biogen, Bayer Schering Pharma, Merck Serono, Novartis, Genzyme, Santhera and Teva Pharmaceutical Industries Ltd./sanofi-aventis.
Jörg Kraus received consulting and/or research funding and/or educational support from Almirall, Bayer, Biogen, Celgene, MedDay, Medtronic, Merck, Novartis, Roche, Sanofi-Aventis, Shire, TEVA ratiopharm.
Stefan Kalcher declares that there is no conflict of interest.
Erich Kvas declares that there is no conflict of interest.
Thomas Berger has participated in meetings sponsored by and received honoraria (lectures, advisory boards, consultations) from pharmaceutical companies marketing treatments for multiple sclerosis: Almirall, Bayer, Biogen, Biologix, Bionorica, Genzyme, MedDay, Merck, Novartis, Octapharma, Roche, Sanofi/Genzyme, TG Pharmaceuticals, TEVA-ratiopharm and UCB. His institution has received financial support in the last 12 months by unrestricted research grants (Biogen, Bayer, Merck, Novartis, Sanofi/Genzyme, and TEVA ratiopharm) and for participation in clinical trials in multiple sclerosis sponsored by Alexion, Bayer, Biogen, Merck, Novartis, Octapharma, Roche, Sanofi/Genzyme, and TEVA.