PMID- 28839949
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220321
IS  - 2055-2173 (Print)
IS  - 2055-2173 (Electronic)
IS  - 2055-2173 (Linking)
VI  - 3
IP  - 3
DP  - 2017 Jul-Sep
TI  - Comparison of fingolimod and dimethyl fumarate in the treatment of multiple 
      sclerosis: Two-year experience.
PG  - 2055217317725102
LID - 10.1177/2055217317725102 [doi]
LID - 2055217317725102
AB  - BACKGROUND: Fingolimod (FTY) and dimethyl fumarate (DMF) are multiple sclerosis 
      (MS) oral therapies that became available in 2010 and 2013, respectively. 
      OBJECTIVE: The objective of this article is to compare discontinuation rates, 
      efficacy, and adverse events (AEs) of FTY and DMF over two years. METHODS: 
      Patients prescribed FTY or DMF at the Rocky Mountain MS Center at University of 
      Colorado prior to October 2013 were identified. Clinician-reported data were 
      retrospectively collected. Primary outcome was discontinuation of drug by the end 
      of year two. Reasons for discontinuation were evaluated. RESULTS: A total of 271 
      FTY and 342 DMF patients were evaluated. Patients had a mean age of 42.5 (FTY) 
      and 45.8 (DMF) years and were predominantly female (72.0% FTY; 69.6% DMF) and 
      white (86.3% FTY; 82.2% DMF). At </=24 months, 93 (34.3%) and 161 (47.1%) 
      discontinued FTY and DMF, respectively, with an unadjusted odds ratio (OR) of 
      1.70 (1.23-2.37, p = 0.002), or 1.69 (1.16-2.46, p = 0.006) for the doubly robust 
      propensity score weighted estimator. Primary reason for discontinuation was AEs, 
      which were less likely for FTY 46 (17.0%) compared to DMF 82 (24.0%) (OR 1.54, 
      1.03-2.31, p = 0.035). Discontinuation due to disease activity (FTY (10%) DMF 
      (11.1%); OR 1.13, 0.67-1.90, p = 0.647) and breakthrough disease activity, 
      regardless of discontinuation (FTY (34.7%) DMF (33.6%); OR 0.95, 0.68-1.34, 
      p = 0.783), were similar. CONCLUSIONS: The odds of discontinuation were less for 
      FTY than DMF, and were driven by AEs for both drugs.
FAU - Vollmer, Brandi
AU  - Vollmer B
AD  - Rocky Mountain MS Center at University of Colorado, USA.
FAU - Nair, Kavita V
AU  - Nair KV
AD  - Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado 
      Denver, United States.
FAU - Sillau, Stefan H
AU  - Sillau SH
AD  - Rocky Mountain MS Center at University of Colorado, USA.
FAU - Corboy, John
AU  - Corboy J
AD  - Rocky Mountain MS Center at University of Colorado, USA.
FAU - Vollmer, Timothy
AU  - Vollmer T
AD  - Rocky Mountain MS Center at University of Colorado, USA.
FAU - Alvarez, Enrique
AU  - Alvarez E
AD  - Rocky Mountain MS Center at University of Colorado, USA.
LA  - eng
PT  - Journal Article
DEP - 20170817
PL  - United States
TA  - Mult Scler J Exp Transl Clin
JT  - Multiple sclerosis journal - experimental, translational and clinical
JID - 101668877
PMC - PMC5564884
OTO - NOTNLM
OT  - Comparative efficacy
OT  - Gilenya
OT  - Tecfidera
OT  - disease-modifying therapy
OT  - real world
EDAT- 2017/08/26 06:00
MHDA- 2017/08/26 06:01
PMCR- 2017/08/17
CRDT- 2017/08/26 06:00
PHST- 2017/04/14 00:00 [received]
PHST- 2017/07/06 00:00 [accepted]
PHST- 2017/08/26 06:00 [entrez]
PHST- 2017/08/26 06:00 [pubmed]
PHST- 2017/08/26 06:01 [medline]
PHST- 2017/08/17 00:00 [pmc-release]
AID - 10.1177_2055217317725102 [pii]
AID - 10.1177/2055217317725102 [doi]
PST - epublish
SO  - Mult Scler J Exp Transl Clin. 2017 Aug 17;3(3):2055217317725102. doi: 
      10.1177/2055217317725102. eCollection 2017 Jul-Sep.