The effectiveness of natalizumab vs fingolimod–A comparison of international registry studies

BackgroundNatalizumab and fingolimod were the first preparations recommended for disease breakthrough in priorly treated relapsing-remitting multiple sclerosis. Of three published head-to-head studies two showed that natalizumab is more effective to prevent relapses EDSS worsening.MethodsBy re-analyzing original results from MSBase, France, Denmark using uniform methodologies, we aimed at identifying effects of differences methodology, MS-populations, re-evaluating effectiveness between drugs.We gained access copies individual amended databases pooled all data. We used inclusion/exclusion criteria statistical methods with Inverse Probability Treatment Weighting.ResultsThe analyses comprised 968 natalizumab- 1479 patients. The on-treatment natalizumab/fingolimod relapse rate ratio was 0.77 (p=0.004). hazard (HR) a 0.82 (p=0.030), HR sustained improvement 1.4 (p=0.009). There modest each replication study, but conclusions remained unchanged: them effective, third there no difference fingolimod.ConclusionThe largely invariant epidemiological differed MS populations. Generally, advantage confirmed.