Background/aim During multiple sclerosis (MS) treatment different modes of action such as lateral (interferon beta to glatiramer acetate or glatiramer acetate to interferon beta) or vertical (interferon beta/glatiramer acetate to fingolimod) drug switch can be performed. This study aims to investigate the clinical effectiveness of switching from the first-line injectable disease modifying treatments (iDMTs) to fingolimod (FNG) compared to switching between first-line iDMTs. Materials and methods This is a multicenter, observational and retrospective study of patients with relapsing-remitting MS who had lateral and vertical switch. The observation period included three key assessment time points (before the switch, at switch, and after the switch). Data were collected from the MS patients’ database by neurologists between January 2018 and June 2019. The longest follow-up period of the patients was determined as 24 months after the switch. Results In 462 MS patients that were included in the study, both treatments significantly decreased the number of relapses during the postswitch 12 months versus preswitch one year while patients in the FNG group experienced significantly fewer relapses compared to iDMT cohort in the postswitch 12 months period. FNG cohort experienced fewer relapses than in the iDMT cohort within the postswitch 2 year. The mean time to first relapse after the switch was significantly longer in the FNG group. Conclusion The present study revealed superior effectiveness of vertical switch over lateral switch regarding the improvement in relapse outcomes. Patients in the FNG cohort experienced sustainably fewer relapses during the follow-up period after the switch compared the iDMT cohort. Importantly, switching to FNG was more effective in delaying time to first relapse when compared with iDMTs.

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Background/aim The purpose of the study was to cross-culturally adapt the Multiple Sclerosis Impact Scale-29 (MSIS-29) into Turkish and evaluate its reliability and validity in patients with Multiple Sclerosis (MS). Materials and methods A total of 119 individuals with MS were enrolled in the research. The neurologist classified the patients with Expanded Disability Status Scale (EDSS). In the initial evaluation, patients completed the Multiple Sclerosis Impact Scale-29 (MSIS-29), the Multiple Sclerosis International Quality of Life (MusiQoL), EuroQol-5D-3L (EQ-5D-3L), and Beck Depression Scale (BDS), respectively one week later, the MSIS-29 evaluation was repeated. Internal consistency, test-retest reliability, and construct validity were assessed, separately. Results The mean age of the total sample was 38.2 ± 10.6 years. The test-retest reliability of both subscores of the MSIS-29 was excellent (>0.80). Internal consistency of the MSIS-29 physical and psychological score was 0.968 and 0.914, respectively. Both of the subscores had excellent internal consistency (>0.80). There was a strong relationship between MSIS-29 physical score with MusiQoL, EQ-5D-3L (index), EQ-5D-3L (VAS), and BDS scores (p < 0.01, r > 0.50). MSIS-29 physical was moderately related to EDSS (p < 0.01, r = 0.381). MSIS-29 psychological score was strongly correlated with MusiQoL, EQ-5D-3L (index), EQ-5D-3L (VAS), and BDS scores (p < 0.01, r > 0.50). On the other hand, there was a weak correlation between MSIS-29 psychological score and EDSS (p < 0.01, r = 0.300). Conclusion Turkish version of the MSIS-29 is a reliable and valid tool in individuals with MS.