Continuous Fingolimod Treatment Leads to 50% Reduction of ARRs

In a recent study, researchers looked to assess the real-world durability of reduction in relapse rates among patients with multiple sclerosis (MS) who continuously received fingolimod (Gilenya) therapy over a longer-term period of follow up.

Study investigators identified patients with MS who had initiated fingolimod therapy and were followed for 3 years post first therapy administration. Although other clinical trials have found reduced annualized relapse rates (ARRs) in patients treated with fingolimod, there have been few long-term real-world studies that examined relapse reduction rates.

The trial included data from 1599 patients who had at least 1 inpatient or 2 outpatient claims and a total of 4 years of continuous health plan enrollment. Among these 1599 patients, all used fingolimod therapy for 1 year (cohort 1), 1158 took it up until the start of year 2 (cohort 2), and 937 took the therapy until the start of year 3.

At baseline, the mean ARR during the 1-year preinitiation period for all cohorts was 0.51. After fingolimod treatment was initiated mean ARRs were consistently lower in each year of follow up: 0.25 (95% CI, 0.22-0.28) in cohort 1, a 51% reduction rate; 0.22 (95% CI, 0.18-0.25) in year 2 for patients in cohort 2, a 54% reduction rate; and 0.23 (95% CI, 0.19-0.27) in year 3 for patients in cohort 3, a 53% reduction.

For continuous-use patients, researchers found an even greater reduction in ARRs. Mean ARRs in continuous-use patients were 0.19 (61% reduction) in the first year, 0.18 (62% reduction) in the second year, and 0.18 (a 61% reduction) at the start of the third year.

Overall, the study authors found that “patients with MS who received continuous fingolimod therapy experienced a sustained reduction in relapse rates (>50% versus baseline) during each year of a 3-year follow up period.”

Reference

Fox E, Vieira MC, Johnson K, et al. Real-world durability of relapse rate reduction in patients with multiple sclerosis receiving fingolimod for up to 3 years: a retrospective US claims database analysis [published online January 22, 2019]. J Neurol Sci. doi: 10.1016/j.jns.2019.01.036.