Highlights
- •Disease activity during treatment predicts poor outcome in Multiple Sclerosis patients.
- •One third of patients on fingolimod treatment was free from disease activity at 5 years.
- •Baseline disability and relapse rate before treatment predict freedom from disease activity.
Abstract
Background and Purpose
Ongoing disease activity during treatment has been associated to worse disability
outcomes in patients with Multiple Sclerosis (MS). The aim of this study was to assess
the 5-year response to fingolimod (FTY) treatment in patients with relapsing-remitting
(RRMS) in a real-life setting.
Methods
We included RRMS patients who received FTY for at least 6 months and had a follow-up
≥ 60 months. Treatment response was assessed through the No Evidence of Disease Activity (NEDA)-3 status.
Results
Eighty-eight patients were included, of which 51 (58.0%) were NTZ-naïve and 37 (42.0%)
NTZ-switchers. The mean age was 38.9 (9.5) years and 58 (65.9%) were females. The
proportion of patients on FTY treatment who maintained the NEDA-3 status at 5 years
was 55.9% among NTZ-naïve patients and 35.0% among NTZ-switchers (p=0.138). Predictors
of NEDA-3 status were lower Expanded Disability Status Scale score at baseline (adjOR=0.28, 95% CI 0.10-0.77; p=0.013) in NTZ-naïve patients and fewer relapses in the
12 months before starting FTY in NTZ-switchers (adjOR=0.05, 95% CI 0.003-0.79; p=0.034).
Conclusions
This study supports the potential of FTY as a disease-modifying treatment for the
long-term management of RRMS patients. Patients with milder disability and fewer clinical
relapses before treatment may achieve a better disease control.
Keywords
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Article info
Publication history
Published online: July 20, 2020
Accepted:
July 20,
2020
Received in revised form:
June 22,
2020
Received:
May 20,
2020
Identification
Copyright
© 2020 Elsevier B.V. All rights reserved.
