Contributions
Abstract: EP1585
Type: Poster Sessions
Abstract Category: Therapy - Immunomodulation/Immunosuppression
Background: In clinical practice, inactive relapsing-remitting multiple sclerosis (RRMS) patients under interferons and glatiramer acetate (collectively known as BRACE therapies) are often reluctant to be kept under an injectable drug when oral alternatives are available. A recent subgroup analysis from TEMSO and TOWER studies showed that patients previously treated with BRACE therapies presented a reduction in relapse rate and in the disability progression after switching to teriflunomide. However, in these patients, MS was active in the 24 months prior to teriflunomide start.
We aimed to evaluate if switching inactive patients under BRACE therapies to teriflunomide maintained their inactive-status or if it was associated with an increase in disease activity.
Methods: We designed a case-control study including all adult patients with the following inclusion criteria: RRMS, inactive under BRACE therapies for at least 2 years according to Lublin criteria, that were subsequently switched to teriflunomide due to injection-related problems (exposure group) or maintained under the injectable DMT (control group), and had a minimum follow up of 6 months. We analyzed the risk of relapse and disability progression between groups using Kaplan-Meier survival curves with the log-rank test and Cox regression.
Results: Of 48 patients included, 32(66.7%) were women, with a mean age of 45.4(± 11.1) and a median disease duration of 11.0 (IQR 9.0) years. The median EDSS at baseline was 1.0 (IQR 1.0). Patients had been under BRACE therapies for a period of 2-16 years. Eleven (22.9%) patients switch to teriflunomide. Switching to teriflunomide did not associate with a higher risk of relapse (HR: 3.528, 95% CI 0.220-56.445; p=0.373) or a higher risk of disability progression (HR:0.317, 95%CI:0.414-15.236; p=0.317) during a median follow-up period of 24 (IQR 0.0) months.
Conclusion: Teriflunomide seemed a good alternative in inactive RRMS patients under BRACE therapies reporting injection-related problems. The transition of these patients to teriflunomide was not associated with a higher risk of relapse or disability progression in our sample. Further studies with larger samples and including radiologic assessments would be useful to confirm if patients controlled with BRACE therapies can be safely switched to teriflunomide in case of injection-related problems.
Disclosure: Filipa Ladeira received consultant fees from Novartis and support for scientific meetings from Biogen Idec, Novartis, Sanofi Genzyme and Teva.
Manuel Salavisa has received support for scientific meetings from Genzyme and Merck Serono.
Claudia Borbinha received support for scientific meetings from Biogen Idec.
João Pedro Marto, Laurete Conceição, Marlene Saraiva and Francisca Sá have no conflicts of interest.
Ana Sofia Correia received an educational sponsorship from Merck Serono, consultant fees from Biogen Idec, Merck Serono, Novartis and Roche, as well as research support from Biogen Idec and support for scientific meetings from Bayer, Biogen Idec, Novartis, Roche, Sanofi Genzyme and Teva
Abstract: EP1585
Type: Poster Sessions
Abstract Category: Therapy - Immunomodulation/Immunosuppression
Background: In clinical practice, inactive relapsing-remitting multiple sclerosis (RRMS) patients under interferons and glatiramer acetate (collectively known as BRACE therapies) are often reluctant to be kept under an injectable drug when oral alternatives are available. A recent subgroup analysis from TEMSO and TOWER studies showed that patients previously treated with BRACE therapies presented a reduction in relapse rate and in the disability progression after switching to teriflunomide. However, in these patients, MS was active in the 24 months prior to teriflunomide start.
We aimed to evaluate if switching inactive patients under BRACE therapies to teriflunomide maintained their inactive-status or if it was associated with an increase in disease activity.
Methods: We designed a case-control study including all adult patients with the following inclusion criteria: RRMS, inactive under BRACE therapies for at least 2 years according to Lublin criteria, that were subsequently switched to teriflunomide due to injection-related problems (exposure group) or maintained under the injectable DMT (control group), and had a minimum follow up of 6 months. We analyzed the risk of relapse and disability progression between groups using Kaplan-Meier survival curves with the log-rank test and Cox regression.
Results: Of 48 patients included, 32(66.7%) were women, with a mean age of 45.4(± 11.1) and a median disease duration of 11.0 (IQR 9.0) years. The median EDSS at baseline was 1.0 (IQR 1.0). Patients had been under BRACE therapies for a period of 2-16 years. Eleven (22.9%) patients switch to teriflunomide. Switching to teriflunomide did not associate with a higher risk of relapse (HR: 3.528, 95% CI 0.220-56.445; p=0.373) or a higher risk of disability progression (HR:0.317, 95%CI:0.414-15.236; p=0.317) during a median follow-up period of 24 (IQR 0.0) months.
Conclusion: Teriflunomide seemed a good alternative in inactive RRMS patients under BRACE therapies reporting injection-related problems. The transition of these patients to teriflunomide was not associated with a higher risk of relapse or disability progression in our sample. Further studies with larger samples and including radiologic assessments would be useful to confirm if patients controlled with BRACE therapies can be safely switched to teriflunomide in case of injection-related problems.
Disclosure: Filipa Ladeira received consultant fees from Novartis and support for scientific meetings from Biogen Idec, Novartis, Sanofi Genzyme and Teva.
Manuel Salavisa has received support for scientific meetings from Genzyme and Merck Serono.
Claudia Borbinha received support for scientific meetings from Biogen Idec.
João Pedro Marto, Laurete Conceição, Marlene Saraiva and Francisca Sá have no conflicts of interest.
Ana Sofia Correia received an educational sponsorship from Merck Serono, consultant fees from Biogen Idec, Merck Serono, Novartis and Roche, as well as research support from Biogen Idec and support for scientific meetings from Bayer, Biogen Idec, Novartis, Roche, Sanofi Genzyme and Teva