Key result
Dimethyl fumarate significantly reduced the annual rate of relapse compared to injectable immunomodulators (RR 0.72) and teriflunomide (RR 0.81) in patients with relapsing-remitting multiple sclerosis.
Why the study?
To assess the real-life comparative effectiveness of dimethyl fumarate on annual relapse rate and disability progression in multiple sclerosis versus injectable immunomodulators, teriflunomide, and fingolimod.
Does dimethyl fumarate reduce the annual rate of relapse and disability progression in patients with multiple sclerosis compared to injectable immunomodulators, teriflunomide, and fingolimod?
Cohort (n=9,304)
Yes
Does dimethyl fumarate reduce the annual rate of relapse and disability progression in patients with multiple sclerosis compared to injectable immunomodulators, teriflunomide, and fingolimod?
In a real-world setting, dimethyl fumarate is associated with a lower risk of relapse compared to injectable immunomodulators and teriflunomide in patients with relapsing-remitting multiple sclerosis.
Dimethyl fumarate was associated with fewer relapses versus some MS therapies in real-world data; leaves open effects on disability and need for randomized confirmation.
Objectives: To assess the effectiveness of dimethyl fumarate (DMF) on annual rate of relapse (ARR) and disability progression in multiple sclerosis (MS) compared to injectable immunomodulators (IMM), teriflunomide (TERI) and fingolimob (FTY), in real life setting. Methods: A population-based cohort study was conducted using data of the French nationwide claims database, SNDS. All patients initiating IMM, TERI, FTY or DMF between July 1, 2015 and December 12, 2017, with 4.5 years of database history and 1 to 3.5 years of follow-up were included in this study. DMF patients were 1:1 matched to IMM, TERI or FTY using a high dimensional Propensity Score. Negative binomial regression and a regression logistic models were used to estimate the relative risk (RR ± [95% CI]) of ARR and the Odds Ratio (OR ± [95% CI]) of disability progression, respectively. Results: Overall, 9 304 subjects were identified: 29.0% initiated DMF, 33.2% TERI, 5.6% FTY and 32.2% an IMM. The matched cohorts consisted of 1779 DMF- IMM, patients, 1679 DMF-TERI patients, and 376 DMF-FTY patients. DMF significantly reduced ARR compared to IMM (RR 0.72 [0.61 - 0.86]) and TERI (0.81 [0.68 - 0.96]). The risk of the progression of MS specific disability was not significantly different for any matched cohorts.Interpretation: DMF is associated with lower risk of relapse for patients with RRMS than other first-line RRMS agents (TERI and IIM).
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Bosco‐Lévy et al. (2021) conducted a cohort in Relapsing-Remitting Multiple Sclerosis (n=9,304). Dimethyl fumarate vs. Injectable immunomodulators, teriflunomide, and fingolimod was evaluated on Annual rate of relapse (ARR) (RR 0.72, 95% CI 0.61 - 0.86). Dimethyl fumarate significantly reduced the annual rate of relapse compared to injectable immunomodulators (RR 0.72) and teriflunomide (RR 0.81) in patients with relapsing-remitting multiple sclerosis.
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