Comparative Effectiveness of Rituximab and Other Initial Treatment Choices for Multiple Sclerosis

↓ Direkt till sidans innehåll
↓ Direkt till sidans sekundära innehåll (sidomenyn)

Search: WFRF:(Frisell Thomas) > (2015-2019) > Comparative Effecti...

Details
MARC

Granqvist, MathiasKarolinska Institutet,Umeå universitet,Klinisk neurovetenskap (author)

Comparative Effectiveness of Rituximab and Other Initial Treatment Choices for Multiple Sclerosis

Article/chapterEnglish2018

Publisher, publication year, extent ...

American Medical Association,2018
printrdacarrier

Numbers

LIBRIS-ID:oai:DiVA.org:umu-146450
https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-146450URI
https://doi.org/10.1001/jamaneurol.2017.4011DOI
http://kipublications.ki.se/Default.aspx?queryparsed=id:137829049URI

Supplementary language notes

Language:English
Summary in:English

Part of subdatabase

SwePubSwePub

Classification

Subject category:ref swepub-contenttype
Subject category:art swepub-publicationtype

Notes

IMPORTANCE Comparative real-world effectiveness studies of initial disease-modifying treatment (DMT) choices for relapsing-remitting multiple sclerosis (RRMS) that include rituximab are lacking.OBJECTIVE To assess the effectiveness and drug discontinuation rates of rituximab among patients with newly diagnosed RRMS compared with injectable DMTs, dimethyl fumarate, fingolimod, or natalizumab.DESIGN, SETTING, AND PATIENTS This retrospective cohort study used prospectively collected data to examine specialized care of 2 Swedish county-based community samples of patients with RRMS. Patients with RRMS who received diagnoses from January 1, 2012, to October 31, 2015, who resided in Stockholm or Vasterbotten Counties were identified from a Swedish multiple sclerosis registry.MAIN OUTCOMES AND MEASURES All reasons for drug discontinuation of initial treatment choice (main outcome) and specific reasons for switching (secondary outcomes) were analyzed with multivariable Cox regression, including propensity scores.RESULTS Among 494 patients (median [interquartile range] age, 34.4 [27.4-43.4] years; 158 men [32.0%]), 215 received an injectable DMT (43.5%); 86 (17.4%), dimethyl fumarate; 17 (3.4%), fingolimod; 50 (10.1%), natalizumab; 120 (24.3%), rituximab; and 6 (1.2%), other DMT. Regional preferences were pronounced, with 42 of 52 (81%) and 78 of 442 (18%) receiving rituximab in Vasterbotten and Stockholm, respectively. The annual discontinuation rate for rituximab, injectable DMTs, dimethyl fumarate, fingolimod, and natalizumab were 0.03, 0.53, 0.32, 0.38, and 0.29, respectively. Continued disease activity was the main reason for discontinuation of injectable DMTs, dimethyl fumarate, and fingolimod; positive John Cunningham virus serology results were the main reason for discontinuation of natalizumab. Rate of clinical relapses and/or neuroradiologic disease activity were significantly lower for rituximab compared with injectable DMTs and dimethyl fumarate, with a tendency for lower relapse rates also compared with natalizumab and fingolimod. The annual discontinuation rate of initial treatment choice was significantly lower in Vasterbotten compared with Stockholm (0.09 and 0.37, respectively).CONCLUSIONS AND RELEVANCE Rituximab was superior to all other DMT in terms of drug discontinuation and displayed better clinical efficacy compared with injectable DMTs and dimethyl fumarate with borderline significance compared with natalizumab and fingolimod. The county where rituximab constituted the main initial treatment choice displayed better outcomes in most measured variables. Collectively, our findings suggest that rituximab performs better than other commonly used DMTs in patients with newly diagnosed RRMS.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Neurologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Neurology hsv//eng

Added entries (persons, corporate bodies, meetings, titles ...)

Boremalm, MalinUmeå universitet,Klinisk neurovetenskap(Swepub:umu)manblm99 (author)
Poorghobad, Amyar (author)
Svenningsson, AndersKarolinska Institutet (author)
Salzer, JonatanUmeå universitet,Klinisk neurovetenskap(Swepub:umu)jonser01 (author)
Frisell, ThomasKarolinska Institutet (author)
Piehl, FredrikKarolinska Institutet (author)
Umeå universitetKlinisk neurovetenskap (creator_code:org_t)

Related titles

In:JAMA Neurology: American Medical Association75:3, s. 320-3272168-61492168-6157

Internet link

Find in a library

JAMA Neurology (Search for host publication in LIBRIS)

To the university's database

Find more in SwePub

By the author/editor: Granqvist, Mathi ...; Boremalm, Malin; Poorghobad, Amya ...; Svenningsson, An ...; Salzer, Jonatan; Frisell, Thomas; show more...; Piehl, Fredrik; show less...

About the subject

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Neurology

Articles in the publication: JAMA Neurology

By the university: Umeå University; Karolinska Institutet

Search outside SwePub

Extend your search to:: Google; Google Book Search; Google Scholar

Kungliga biblioteket hanterar dina personuppgifter i enlighet med EU:s dataskyddsförordning (2018), GDPR. Läs mer om hur det funkar här.
Så här hanterar KB dina uppgifter vid användning av denna tjänst.

LIBRIS.kb.se