Comparative Effectiveness of Natalizumab Versus Anti-CD20 in Highly Active Relapsing-Remitting Multiple Sclerosis After Fingolimod Withdrawal - Archive ouverte HAL Accéder directement au contenu
Article Dans Une Revue Neurotherapeutics Année : 2022

Comparative Effectiveness of Natalizumab Versus Anti-CD20 in Highly Active Relapsing-Remitting Multiple Sclerosis After Fingolimod Withdrawal

1 CRNL - Centre de recherche en neurosciences de Lyon - Lyon Neuroscience Research Center
2 HCL - Hospices Civils de Lyon
3 Fondation Eugène Devic EDMUS
4 CHU Nantes - Centre Hospitalier Universitaire de Nantes
5 CIC Plurithématique de Nantes
6 Service de neurologie [Nantes]
7 APEMAC - Adaptation, mesure et évaluation en santé. Approches interdisciplinaires
8 Service de neurologie [CHRU Nancy]
9 APHM - Assistance Publique - Hôpitaux de Marseille
10 CEMEREM - Centre d'Exploration Métabolique par Résonance Magnétique [Hôpital de la Timone - APHM]
11 CHU Strasbourg - Centre Hospitalier Universitaire [Strasbourg]
12 Département de neurologie [Montpellier]
13 U1215 Inserm - UB - Neurocentre Magendie : Physiopathologie de la Plasticité Neuronale
14 Service de neurologie [Bordeaux]
15 Pôle NIRR - Service de Neurologie [CHU Nimes]
16 IGF - Institut de Génomique Fonctionnelle
17 Infinity - Institut Toulousain des Maladies Infectieuses et Inflammatoires
18 Service de Neurologie [CHRU Besançon]
19 CHU Rothschild [AP-HP]
20 Service de Neurologie [CHU Clermont-Ferrand]
21 CHU Saint-Antoine [AP-HP]
22 CHUGA - Centre Hospitalier Universitaire [CHU Grenoble]
23 Service de neurologie [Rouen]
24 Institut de recherche sur le cancer
25 CHU Dijon - Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand
26 Service de Neurologie [CHU Nice]
27 CHU Pitié-Salpêtrière [AP-HP]
28 CIC - Centre d'Investigation Clinique [Rennes]
29 Service de Neurologie [CHU Rennes]
30 Service de neurologie [Poitiers]
31 SLA CHU Limoges - Centre référent Sclérose Latérale Amyotrophique et autres maladies du motoneurone [CHU Limoges]
32 Service de Neurologie [CHU Limoges]
33 Service de neurologie [Fort-de-France, Martinique]
34 Service de Neurologie [CHU de Saint-Étienne]
35 Service de Neurologie [CHU Caen]
36 Hôpital Sud Francilien Corbeil-Essonnes
37 CHU Trousseau [Tours]
38 Service de neurologie [CH Saint Denis]
39 Centre Hospitalier René Dubos [Pontoise]
40 REPERES - Recherche en Pharmaco-épidémiologie et Recours aux Soins
41 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
42 U1064 Inserm - CR2TI - Centre de Recherche en Transplantation et Immunologie - Center for Research in Transplantation and Translational Immunology
Pierre Labauge
Olivier Gout
  • Fonction : Auteur
  • PersonId : 946000
  • IdRef : 052535118
Bruno Stankoff
Christine Lebrun-Frenay

Résumé

In France, two therapeutic strategies can be offered after fingolimod (FNG) withdrawal to highly active relapsing-remitting multiple sclerosis (RRMS) patients: natalizumab (NTZ) or anti-CD20. We compared the effectiveness of these two strategies as a switch for FNG within the OFSEP database. The primary endpoint was the time to first relapse. Other outcomes were the relapse rates over 3-month periods, time to worsening the EDSS score, proportion of patients with worsened 24-month MRI, time to treatment discontinuation, and incidence rates of serious adverse events. The dynamics of event rates over time were modeled using multidimensional penalized splines, allowing the possibility to model the effects of covariates in a flexible way, considering non-linearity and interactions. A total of 740 patients were included (337 under anti-CD20 and 403 under NTZ). There was no difference between the two treatments regarding the dynamic of the first occurrence of relapse, with a monthly probability of 5.0% at initiation and 1.0% after 6 months. The rate of EDSS worsening increased in both groups until 6 months and then decreased. No difference in the proportion of patients with new T2 lesions at 24 months was observed. After 18 months of follow-up, a greater risk of NTZ discontinuation was found compared to anti-CD20. This study showed no difference between NTZ and anti-CD20 after the FNG switch regarding the clinical and radiological activity. The effect of these treatments was optimal after 6 months and there was more frequent discontinuation of NTZ after 18 months, probably mainly related to JC virus seroconversions.

Dates et versions

hal-03594074 , version 1 (11-10-2023)

Identifiants

Citer

Fabien Rollot, Justine Couturier, Romain Casey, Sandrine Wiertlewski, Marc Debouverie, et al.. Comparative Effectiveness of Natalizumab Versus Anti-CD20 in Highly Active Relapsing-Remitting Multiple Sclerosis After Fingolimod Withdrawal. Neurotherapeutics, 2022, 19 (2), pp.476-490. ⟨10.1007/s13311-022-01202-1⟩. ⟨hal-03594074⟩
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