Premium
Therapeutic outcome 3 years after switching of immunomodulatory therapies in patients with relapsing–remitting multiple sclerosis in Argentina
Author(s) -
Carrá A.,
Onaha P.,
Luetic G.,
Burgos M.,
Crespo E.,
Deri N.,
Halfon M.,
Jaacks G.,
López A.,
Sinay V.,
Vrech C.
Publication year - 2008
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/j.1468-1331.2008.02071.x
Subject(s) - medicine , glatiramer acetate , mitoxantrone , multiple sclerosis , expanded disability status scale , relapsing remitting , natalizumab , observational study , chemotherapy , immunology
Switching treatment may be beneficial in patients with relapsing–remitting multiple sclerosis (RRMS) who respond inadequately to first‐line immunomodulatory therapy. The objective of this study was to evaluate clinical outcomes after switching treatment in such patients. This prospective longitudinal observational study included 114 patients with RRMS who failed first‐line monotherapy and were switched treatments after 3 years. Every 3 months, patients underwent a full neurological examination. Outcome was compared between the 3‐year Before Switch and After Switch treatment periods. The primary outcome measure was the annualized relapse rate; secondary outcome measures were the proportion of relapse‐free patients and the median change in Expanded Disability Status Scale (EDSS). Patients were switched either from low‐dose to high‐dose interferon‐β (IFNβ; n = 31), from IFNβ to glatiramer acetate (GA; n = 52) or mitoxantrone ( n = 13), or from GA to IFNβ ( n = 16). In 3 years after switching, annualized relapse rates fell by 57–78% according to the group. The proportion of relapse‐free patients varied from 56% to 81%. Least improved was observed in patients switching between INFβ preparations. Median EDSS scores remained stable in all groups except the GA to IFNβ switchers. In conclusion, patients who fail first‐line immunomodulatory therapy generally benefit from switching to another class of immunomodulatory therapy.