Comparative effectiveness of glatiramer acetate and interferon beta formulations in relapsing–remitting multiple sclerosis. (August 2015)

• Record Type: Journal Article
• Authors: Kalincik, Tomas; Jokubaitis, Vilija; Izquierdo, Guillermo; Duquette, Pierre; Girard, Marc; Grammond, Pierre; Lugaresi, Alessandra; Oreja-Guevara, Celia; Bergamaschi, Roberto; Hupperts, Raymond; Grand'Maison, Francois; Pucci, Eugenio; Van Pesch, Vincent; Boz, Cavit; Iuliano, Gerardo; Fernandez-Bolanos, Ricardo; Flechter, Shlomo; Spitaleri, Daniele; Cristiano, Edgardo; Verheul, Freek; Lechner-Scott, Jeannette; Amato, Maria Pia; Cabrera-Gomez, Jose Antonio; Saladino, Maria Laura; Slee, Mark; Moore, Fraser; Gray, Orla; Paine, Mark; Barnett, Michael; Havrdova, Eva; Horakova, Dana; Spelman, Timothy; Trojano, Maria; Butzkueven, Helmut;
• Other Names: Roullet Etienne non-byline-author.; Rozsa Csilla non-byline-author.; Kasa Krisztian non-byline-author.; Sirbu Carmen-Adella non-byline-author.; Shaw Cameron non-byline-author.; Vucic Steve non-byline-author.; Petkovska-Boskova Tatjana non-byline-author.; Herbert Joseph non-byline-author.; Kister Ilya non-byline-author.; Singhal Bhim non-byline-author.; Alroughani Raed non-byline-author.; Bacile Elizabeth Alejandra Bacile non-byline-author.; Arruda Walter Oleschko non-byline-author.; Roger Elaine non-byline-author.; Despault Pierre non-byline-author.; Marriott Mark non-byline-author.; Van der Walt Anneke non-byline-author.; King John non-byline-author.; Byron Jill non-byline-author.; Morgan Lisa non-byline-author.; Hinson Eloise non-byline-author.; Haartsen Jodi non-byline-author.; Mechati Samir non-byline-author.; Bianchi Erich non-byline-author.; Bulla Alexandre non-byline-author.; Corageoud Matthieu non-byline-author.; De Luca Giovanna non-byline-author.; Di Tommaso Valeria non-byline-author.; Travaglini Daniela non-byline-author.; Pietrolongo Erika non-byline-author.; di Ioia Maria non-byline-author.; Farina Deborah non-byline-author.; Mancinelli Luca non-byline-author.; Rojas Juan Ignacio non-byline-author.; Patrucco Liliana non-byline-author.; Elisabetta non-byline-author.;
• Is Part Of: Multiple sclerosis. Volume 21:Number 9(2015)
• Page Start: 1159
• Page End: 1171
• Publication Date: 2015-08
• Subjects: Multiple sclerosis -- treatment outcomes -- patient registry -- real-world date -- propensity score -- relapses -- disability; Central nervous system -- Diseases -- Periodicals; Myelin sheath -- Diseases -- Periodicals; Inflammation -- Periodicals; Multiple sclerosis -- Periodicals; Central Nervous System Diseases -- Periodicals; Demyelinating Diseases -- Periodicals; Inflammation -- Periodicals; Multiple Sclerosis -- Periodicals; Système nerveux central -- Maladies -- Périodiques; Gaine de myéline -- Maladies -- Périodiques; Inflammation (Pathologie) -- Périodiques; Sclérose en plaques -- Périodiques; Electronic journals; 616.834005
• DOI: 10.1177/1352458514559865
• Languages: English
• ISSNs: 1352-4585

Abstract

Background: The results of head-to-head comparisons of injectable immunomodulators (interferon β, glatiramer acetate) have been inconclusive and a comprehensive analysis of their effectiveness is needed. Objective: We aimed to compare, in a real-world setting, relapse and disability outcomes among patients with multiple sclerosis (MS) treated with injectable immunomodulators. Methods: Pairwise analysis of the international MSBase registry data was conducted using propensity-score matching. The four injectable immunomodulators were compared in six head-to-head analyses of relapse and disability outcomes using paired mixed models or frailty proportional hazards models adjusted for magnetic resonance imaging variables. Sensitivity and power analyses were conducted. Results: Of the 3326 included patients, 345–1199 patients per therapy were matched (median pairwise-censored follow-up was 3.7 years). Propensity matching eliminated >95% of the identified indication bias. Slightly lower relapse incidence was found among patients treated with glatiramer acetate or subcutaneous interferon β-1a relative to intramuscular interferon β-1a and interferon β-1b ( p ≤0.001). No differences in 12-month confirmed progression of disability were observed. Conclusion: Small but statistically significant differences in relapse outcomes exist among the injectable immunomodulators. MSBase is sufficiently powered to identify these differences and reflects practice in tertiary MS centres. While the present study controlled indication, selection and attrition bias, centre-dependent variance in data quality was likely.