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. 2022 Feb;28(2):237-246.
doi: 10.1177/13524585211019649. Epub 2021 Jun 3.

A comparative study of teriflunomide and dimethyl fumarate within the Swedish MS Registry

Jan Hillert  1 , Jon A Tsai  2 , Mona Nouhi  2 , Anna Glaser  1 , Tim Spelman  1
Affiliations

A comparative study of teriflunomide and dimethyl fumarate within the Swedish MS Registry

Jan Hillert et al. Mult Scler. 2022 Feb.

Abstract

Background: Teriflunomide and dimethyl fumarate (DMF) are first-line disease-modifying treatments for multiple sclerosis with similar labels that are used in comparable populations.

Objectives: The objective of this study was to compare the effectiveness and persistence of teriflunomide and DMF in a Swedish real-world setting.

Methods: All relapsing-remitting multiple sclerosis (RRMS) patients in the Swedish MS registry initiating teriflunomide or DMF were included in the analysis. The primary endpoint was treatment persistence. Propensity score matching was used to adjust comparisons for baseline confounders.

Results: A total of 353 teriflunomide patients were successfully matched to 353 DMF. There was no difference in the rate of overall treatment discontinuation by treatment group across the entire observation period (hazard ratio (HR) = 1.12; 95% confidence interval (CI) = 0.91-1.39; p = 0.277; reference = teriflunomide). Annualised relapse rate (ARR) was comparable (p = 0.237) between DMF (0.07; 95% CI = 0.05-0.10) and teriflunomide (0.09; 95% CI = 0.07-0.12). There was no difference in time to first on-treatment relapse (HR = 0.78; 95% CI = 0.50-1.21), disability progression (HR = 0.55; 95% CI = 0.27-1.12) or confirmed improvement (HR = 1.17; 95% CI = 0.57-2.36).

Conclusion: This population-based real-world study reports similarities in treatment persistence, clinical effectiveness and quality of life outcomes between teriflunomide and dimethyl fumarate.

Keywords: Dimethyl fumarate; multiple sclerosis; teriflunomide; treatment response.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship and/or publication of this article: J.H. has received honoraria for serving on advisory boards for Biogen, Celgene, Sanofi, Merck KGaA, Novartis and Sandoz and speaker’s fees from Biogen, Novartis, Merck KGaA, Teva and Sanofi. He has served as PI for projects, or received unrestricted research support from, Biogen, Celgene, Merck KGaA, Novartis, Roche and Sanofi. His MS research was funded by the Swedish Research Council and the Swedish Brain foundation. J.A.T. and M.N. are employees of Sanofi and may hold shares and/or stock options in the company. A.G. has received research support from Novartis. T.S. has received compensation for serving on scientific advisory boards, honoraria for consultancy and funding for travel from Biogen Inc and speaker honoraria from Novartis

Figures

Figure 1.
Figure 1.
Kaplan–Meier curve – time to treatment discontinuation by drug.
Figure 2.
Figure 2.
Kaplan–Meier curve – time to first on-treatment relapse by drug.
Figure 3.
Figure 3.
Kaplan–Meier curve – time to confirmed disability worsening by drug.
Figure 4.
Figure 4.
Kaplan–Meier curve – time to confirmed EDSS improvement by drug.
Figure 5.
Figure 5.
(a) Teriflunomide and (b) DMF – trend in MSIS-29 psychological scores.
Figure 6.
Figure 6.
(a) Teriflunomide and (b) DMF – trend in MSIS-29 physical scores.
See this image and copyright information in PMC

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References

    1. GBD 2016 Multiple Sclerosis Collaborators. Global, regional, and national burden of multiple sclerosis 1990-2016: A systematic analysis for the Global Burden of Disease Study. Lancet Neurol 2016; 18(3): 269–285. - PMC - PubMed
    1. Confavreux C, O’Connor P, Comi G, et al.. Oral teriflunomide for patients with relapsing multiple sclerosis (TOWER): A randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Neurol 2014; 13(3): 247–256. - PubMed
    1. O’Connor P, Wolinsky JS, Confavreux C, et al.. Randomized trial of oral teriflunomide for relapsing multiple sclerosis. New Engl J Med 2011; 365(14): 1293–1303. - PubMed
    1. Vermersch P, Czlonkowska A, Grimaldi LM, et al.. Teriflunomide versus subcutaneous interferon beta-1a in patients with relapsing multiple sclerosis: A randomised, controlled phase 3 trial. Mult Scler 2014; 20(6): 705–716. - PubMed
    1. Miller AE, Wolinsky JS, Kappos L, et al.. Oral teriflunomide for patients with a first clinical episode suggestive of multiple sclerosis (TOPIC): A randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Neurol 2014; 13(10): 977–986. - PubMed

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