Ospedale San Raffaele
Neurology

Author Of 1 Presentation

Observational Studies Poster Presentation

P0852 - Clinical activity after fingolimod treatment in naïve RRMS patients compared to patients previously treated with other drugs (ID 1304)

Speakers
Presentation Number
P0852
Presentation Topic
Observational Studies

Abstract

Background

Fingolimod is a highly effective drug, with a significant proportion of subjects showing no evidence of disease activity (NEDA) at 2-years follow-up. However, it is not known whether the previous treatment history may influence clinical outcomes under fingolimod.

Objectives

To assess NEDA status in a Italian cohort of relapsing remitting (RR) MS patients treated with fingolimod (FTY), comparing naïve patients with patients previously treated with first-line and second-line drugs.

Methods

543 RRMS patients, who started fingolimod treatment at San Raffaele Hospital (Milan) between 2011 and 2018 were enrolled in the study. Patients were divided in three categories, according to the previous treatment: naïve patients (group 1, n=74), patients previously treated with first-line drugs (group 2, n=315) and patients previously treated with second-line and immunosuppressive drugs (group 3, n=146). NEDA status was assessed at two-year follow-up. Baseline characteristics were investigated in association with NEDA status, using logistic regression in univariable and multivariable models.

Results

Overall, 45.6% patients were NEDA (n=227) at 2-year follow-up; specifically 62.1% patients belonging to group 1, 47.4% to group 2 and 33.6% to group 3 respectively. In the multivariable analysis we observed that patients treated with a first-line and second-line therapy had an increased risk of being EDA (OR=2.2, p=0.036 and OR=3.9, p<0.001 respectively) compared to naïve patients. Moreover, a higher number of new/active MRI lesions (OR, 1.2, p=0.004), a higher annualized relapse rate in the 2 years before (OR=1.3, p=0.03) and a younger age (OR=0.97, p=0.01) at onset were independently associated with increased risk of being EDA.

Conclusions

We confirmed FTY effectiveness in a large monocentric cohort of Italian RRMS patients. Moreover, patients treated with FTY as first drug had a higher probability of being NEDA after 2 years compared to patients previously treated with second-line but also first-line drugs. These data suggest an early use of FTY in naïve patients with high inflammatory activity, considering the better clinical outcomes observed at short-term follow-up.

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