BACKGROUND: No head-to-head study has been performed yet to assess whether natalizumab is more effective than classical immunomodulators in multiple sclerosis (MS). AIM: To retrospectively compare the efficacy of natalizumab vs IFN beta 1a SC (44 μg; Rebif(®) ) on clinical and radiological findings in two matched cohorts of patients with MS. PATIENTS AND METHODS: We retrospectively enrolled two cohorts of 42 patients (F/M: 35/7) with relapsing-remitting multiple sclerosis treated with natalizumab or IFN beta 1a for at least 12 consecutive months. Outcome measures were annualized relapse rate (ARR), changes in expanded disability status scale (EDSS) score, and number of contrast-enhancing lesions (CELs) at magnetic resonance imaging (MRI). RESULTS: In both groups, the ARR in the 12 months of treatment was lower than in the 12 months before therapy (0.24 vs 1.50 in natalizumab-treated group, P < 0.0000; 0.55 vs 1.10 in IFN beta 1a-treated group, P = 0.0006), being the effect of natalizumab significantly stronger (P = 0.0125). EDSS reduction was significantly different between the two groups in favor of natalizumab (P = 0.0018). The frequency and number of CELs per patient were decreased in both groups. In the second year, the treatment affected ARR and EDSS progression in the two groups of patients similarly to the first year, whereas number of CELs decreased more significantly in natalizumab group (P = 0.008). CONCLUSIONS: After 12 and 24 months of therapy, natalizumab was more effective than IFN beta 1a SC on both disease activity and disability progression. Prospective head-to-head studies would be helpful to further evaluate the differences observed in the MRI outcomes.
BACKGROUND: No head-to-head study has been performed yet to assess whether natalizumab is more effective than classical immunomodulators in multiple sclerosis (MS). AIM: To retrospectively compare the efficacy of natalizumab vs IFN beta 1a SC (44 μg; Rebif(®) ) on clinical and radiological findings in two matched cohorts of patients with MS. PATIENTS AND METHODS: We retrospectively enrolled two cohorts of 42 patients (F/M: 35/7) with relapsing-remitting multiple sclerosis treated with natalizumab or IFN beta 1a for at least 12 consecutive months. Outcome measures were annualized relapse rate (ARR), changes in expanded disability status scale (EDSS) score, and number of contrast-enhancing lesions (CELs) at magnetic resonance imaging (MRI). RESULTS: In both groups, the ARR in the 12 months of treatment was lower than in the 12 months before therapy (0.24 vs 1.50 in natalizumab-treated group, P < 0.0000; 0.55 vs 1.10 in IFN beta 1a-treated group, P = 0.0006), being the effect of natalizumab significantly stronger (P = 0.0125). EDSS reduction was significantly different between the two groups in favor of natalizumab (P = 0.0018). The frequency and number of CELs per patient were decreased in both groups. In the second year, the treatment affected ARR and EDSS progression in the two groups of patients similarly to the first year, whereas number of CELs decreased more significantly in natalizumab group (P = 0.008). CONCLUSIONS: After 12 and 24 months of therapy, natalizumab was more effective than IFN beta 1a SC on both disease activity and disability progression. Prospective head-to-head studies would be helpful to further evaluate the differences observed in the MRI outcomes.
Authors: Tim Spelman; Tomas Kalincik; Vilija Jokubaitis; Annie Zhang; Fabio Pellegrini; Heinz Wiendl; Shibeshih Belachew; Robert Hyde; Freek Verheul; Alessandra Lugaresi; Eva Havrdová; Dana Horáková; Pierre Grammond; Pierre Duquette; Alexandre Prat; Gerardo Iuliano; Murat Terzi; Guillermo Izquierdo; Raymond M M Hupperts; Cavit Boz; Eugenio Pucci; Giorgio Giuliani; Patrizia Sola; Daniele L A Spitaleri; Jeannette Lechner-Scott; Roberto Bergamaschi; François Grand'Maison; Franco Granella; Ludwig Kappos; Maria Trojano; Helmut Butzkueven Journal: Neurol Clin Pract Date: 2016-04
Authors: Julia Button; Omar Al-Louzi; Andrew Lang; Pavan Bhargava; Scott D Newsome; Teresa Frohman; Laura J Balcer; Elliot M Frohman; Jerry Prince; Peter A Calabresi; Shiv Saidha Journal: Neurology Date: 2017-01-11 Impact factor: 9.910
Authors: R Lanzillo; S Bonavita; M Quarantelli; G Vacca; G Lus; L Amato; A Carotenuto; G Tedeschi; G Orefice; V Brescia Morra Journal: Neurol Sci Date: 2012-04-22 Impact factor: 3.307