Search: (L773:1352 4585 OR L773:1477 0970) srt2:(2020-2024) >
Comparative effecti...
Comparative effectiveness of dimethyl fumarate as the initial and secondary treatment for MS
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- Granqvist, Mathias (author)
- Karolinska Institutet
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- Burman, Joachim, 1974- (author)
- Uppsala universitet,Landtblom: Neurovetenskap,Uppsala Univ, Sweden
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- Gunnarsson, Martin, 1973- (author)
- Örebro universitet,Institutionen för medicinska vetenskaper,Örebro Univ, Sch Med Sci, Örebro, Sweden.
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- Lycke, Jan, 1956 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap,Institute of Neuroscience and Physiology, Department of Clinical Neuroscience
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- Nilsson, Petra (author)
- Neurology Clinic, Skåne University Hospital, Lund, Sweden
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- Olsson, Tomas (author)
- Karolinska Institutet
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- Sundström, Peter (author)
- Umeå universitet,Klinisk neurovetenskap,Skane Univ Hosp, Neurol Clin, Lund, Sweden.;Umeå Univ, Dept Pharmacol & Clin Neurosci, Umeå, Sweden.
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- Svenningsson, Anders (author)
- Karolinska Institutet
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- Vrethem, Magnus, 1955- (author)
- Linköpings universitet,Avdelningen för neurobiologi,Medicinska fakulteten,Region Östergötland, Neurologiska kliniken i Linköping
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- Frisell, Thomas (author)
- Karolinska Institutet
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- Piehl, Fredrik (author)
- Karolinska Institutet
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(creator_code:org_t)
- 2019-08-08
- 2020
- English.
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In: Multiple Sclerosis Journal. - : Sage Publications. - 1352-4585 .- 1477-0970. ; 26:12, s. 1532-1539
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Abstract
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- BACKGROUND: Population-based real-world evidence studies of the effectiveness and tolerability of dimethyl fumarate in relation to common treatment alternatives are still limited.OBJECTIVE: To evaluate the clinical effectiveness and tolerability of dimethyl fumarate (DMF) as the initial and secondary treatment for relapsing-remitting multiple sclerosis (RRMS) patients compared with common treatment alternatives in Sweden.METHODS: We conducted a nationwide retrospective observational cohort study of all RRMS patients identified through the Swedish MS registry initiating DMF (n = 641) or interferons/glatiramer acetate (IFN/GA; n = 555) as the initial therapy, or DMF (n = 703) or fingolimod (FGL; n = 194) after switch from IFN/GA between 1 January 2014 and 31 December 2016.RESULTS: The discontinuation rate was lower with DMF as the initial treatment than IFN/GA (adjusted hazard rate (HR): 0.46, 95% confidence interval (CI): 0.37-0.58, p < 0.001), but higher than FGL as the secondary treatment (HR: 1.51, CI: 1.08-2.09, p < 0.05). Annualized relapse rate (ARR) was lower with DMF compared to IFN/GA (0.04, CI: 0.03-0.06 vs 0.10, CI: 0.07-0.13; p < 0.05), but not FGL (0.03, CI: 0.02-0.05 vs 0.02, CI: 0.01-0.04; p = 0.41). Finally, time to first relapse (TTFR) was longer with DMF as the initial, but not secondary, therapy (p < 0.05 and p = 0.20, respectively).CONCLUSION: Our findings indicate that DMF performs better than IFN/GA as the initial treatment for RRMS. Compared to FGL, DMF displayed a lower tolerability, but largely similar effectiveness outcomes.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Health Care Service and Management, Health Policy and Services and Health Economy (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Neurologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Neurology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Reumatologi och inflammation (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Rheumatology and Autoimmunity (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Medicinska och farmaceutiska grundvetenskaper -- Neurovetenskaper (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Basic Medicine -- Neurosciences (hsv//eng)
Keyword
- Multiple sclerosis
- dimethyl fumarate
- fingolimod
- glatiramer acetate
- interferon-beta
- relapsing-remitting
- dimethyl fumarate
- fingolimod
- glatiramer acetate
- interferon-beta
- Multiple sclerosis
- relapsing-remitting
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Granqvist, Mathi ...
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Burman, Joachim, ...
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Gunnarsson, Mart ...
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Lycke, Jan, 1956
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Nilsson, Petra
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Olsson, Tomas
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show more...
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Sundström, Peter
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Svenningsson, An ...
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Vrethem, Magnus, ...
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Frisell, Thomas
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Piehl, Fredrik
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Health Sciences
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and Health Care Serv ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Neurology
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Rheumatology and ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Basic Medicine
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and Neurosciences
- Articles in the publication
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Multiple Scleros ...
- By the university
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Örebro University
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Umeå University
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Uppsala University
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Linköping University
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Karolinska Institutet
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University of Gothenburg