Switching to Second-Line Therapies in Interferon-Beta-Treated Relapsing-Remitting Multiple Sclerosis Patients

Portaccio, Emilio; Zipoli, Valentina; Siracusa, G.; Sorbi, Sandro; Amato, Maria Pia

doi:10.1159/000189271

Cited by 11 publications

(6 citation statements)

References 41 publications

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“…reduced ARR, delayed disease progression) was observed in patients who converted from one DMT to another [5, 6, 14, 40–43]. Our findings also emphasize the importance of changing a therapeutic regimen to improve patients’ well-being (i.e.…”

Section: Discussionsupporting

confidence: 56%

A 2-year observational study of patients with relapsing-remitting multiple sclerosis converting to glatiramer acetate from other disease-modifying therapies: the COPTIMIZE trial

et al. 2014

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Studies suggest that patients with relapsing-remitting multiple sclerosis (RRMS) who do not benefit from other disease-modifying treatments (DMTs) may benefit from converting to glatiramer acetate (GA). COPTIMIZE was a 24-month observational study designed to assess the disease course of patients converting to GA 20 mg daily from another DMT. Eligible patients had converted to GA and had received prior DMT for 3–6 months, depending on the reasons for conversion. Patients were assessed at baseline and at 6, 12, 18, and 24 months. In total, 672 patients from 148 centers worldwide were included in the analysis. Change of therapy to GA was prompted primarily by lack of efficacy (53.6 %) or intolerable adverse events (AEs; 44.8 %). Over a 24-month period, 72.7 % of patients were relapse free. Mean annual relapse rate decreased from 0.86 [95 % confidence interval (CI) 0.81–0.91] before the change to 0.32 (95 % CI 0.26–0.40; p < 0.0001) at last observation, while the progression of disability was halted, as the Kurtzke Expanded Disability Status Scale (EDSS) scores remained stable. Patients improved significantly (p < 0.05) on measures of fatigue, quality of life, depression, and cognition; mobility scores remained stable. The results indicate that changing RRMS patients to GA is associated with positive treatment outcomes.

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Section: Discussionsupporting

confidence: 56%

A 2-year observational study of patients with relapsing-remitting multiple sclerosis converting to glatiramer acetate from other disease-modifying therapies: the COPTIMIZE trial

et al. 2014

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“…On the whole, considering that 122 patients (35%) stopped treatment, this could limit the use of MMF in patients with MS. However, such a discontinuation rate of therapy is also observed with interferon b in patients with MS 19. Our results concerning safety are in agreement with data found in previous studies: in 2004, a study of 79 MS patients treated with MMF suggested a good safety profile with potential therapeutic effects 13.…”

Section: Discussionsupporting

confidence: 92%

Mycophenolate mofetil in multiple sclerosis: a multicentre retrospective study on 344 patients

Michel¹,

Vukusic

Seze

et al. 2013

Journal of Neurology, Neurosurgery & Psychiatry

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“…First, it has proven difficult to validate definitions of treatment failure for clinical use; some factors for consideration are listed in Table 5. [114][115][116][117] Second, more work is needed to understand the types of short-term change that might predict longer-term prognosis. 118 Third, there are few head-to-head DMT trials or trials that assess specific DMTs as a next option specifically in the setting of failure of another DMT.…”

Section: Sequential Dmt Monotherapymentioning

confidence: 99%

Multiple Sclerosis: Current and Emerging Disease-Modifying Therapies and Treatment Strategies

Wingerchuk

Carter

2014

Mayo Clinic Proceedings

386

332

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Multiple sclerosis (MS) is a chronic inflammatory demyelinating central nervous system disease that typically strikes young adults, especially women. The pathobiology of MS includes inflammatory and neurodegenerative mechanisms that affect both white and gray matter. These mechanisms underlie the relapsing, and often eventually progressive, course of MS, which is heterogeneous; confident prediction of long-term individual prognosis is not yet possible. However, because revised MS diagnostic criteria that incorporate neuroimaging data facilitate early diagnosis, most patients are faced with making important long-term treatment decisions, most notably the use and selection of disease-modifying therapy (DMT). Currently, there are 10 approved MS DMTs with varying degrees of efficacy for reducing relapse risk and preserving neurological function, but their long-term benefits remain unclear. Moreover, available DMTs differ with respect to the route and frequency of administration, tolerability and likelihood of treatment adherence, common adverse effects, risk of major toxicity, and pregnancy-related risks. Thorough understanding of the benefit-risk profiles of these therapies is necessary to establish logical and safe treatment plans for individuals with MS. We review the available evidence supporting risk-benefit profiles for available and emerging DMTs. We also assess the place of individual DMTs within the context of several different MS management strategies, including those currently in use (sequential monotherapy, escalation therapy, and induction and maintenance therapy) and others that may soon become feasible (combination approaches and "personalized medicine"). We conducted this review using a comprehensive search of MEDLINE, PubMed, EMBASE, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials, from January 1, 1990, to August 31, 2013. The following search terms were used: multiple sclerosis, randomized controlled trials, interferon-beta, glatiramer acetate, mitoxantrone, natalizumab, fingolimod, teriflunomide, dimethyl fumarate, BG-12, alemtuzumab, rituximab, ocrelizumab, daclizumab, neutralizing antibodies, progressive multifocal leukoencephalopathy.

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Switching to Second-Line Therapies in Interferon-Beta-Treated Relapsing-Remitting Multiple Sclerosis Patients

Cited by 11 publications

References 41 publications

A 2-year observational study of patients with relapsing-remitting multiple sclerosis converting to glatiramer acetate from other disease-modifying therapies: the COPTIMIZE trial

A 2-year observational study of patients with relapsing-remitting multiple sclerosis converting to glatiramer acetate from other disease-modifying therapies: the COPTIMIZE trial

Mycophenolate mofetil in multiple sclerosis: a multicentre retrospective study on 344 patients

Multiple Sclerosis: Current and Emerging Disease-Modifying Therapies and Treatment Strategies

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