Natalizumab Compared to Fingolimod in Relapsing-Remitting MS

Natalizumab and fingolimod have never been directly compared
Natalizumab and fingolimod have never been directly compared

A recent analysis published in PLOS One indicates that natalizumab may be more effective than fingolimod in reducing disease activity in patients with relapsing-remitting multiple sclerosis (RRMS)

Until this study, natalizumab and fingolimod have never been directly compared in a randomized clinical trial. Researchers used data from placebo-controlled randomized controlled trials for indirect comparisons, and observational data was used for head-to-head comparisons. Three trials enrolling 2,498 patients and 5 observational studies enrolling 2,576 patients were identified. 

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Study authors found that natalizumab was associated with a greater decrease in the 2-year annualized relapse rate (ARR; P=0.005) and the probability of no disease activity at 2 years (OR 1.82, 95% CI: 1.05–3.15) vs. fingolimod. No differences, however, were seen between the two treatments in the proportion of patients who remained relapse free (OR 1.20, 95% CI: 0.48–1.21) at 2 years. 

Further, in the observational data, no differences between natalizumab and fingolimod in the 2-year ARR and 2-year disability progression were noted. Patients treated with natalizumab, however, were more likely to remain relapse-free at 2 years vs. fingolimod-treated patients (OR 2.19, 95% CI: 1.15–4.18).

Additional head-to-head randomized controlled trials are needed to independently confirm these findings, researchers added.

For more information visit journals.plos.org.

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