Multiple sclerosis: QoL higher with dimethyl fumarate than fingolimod

  • Curr Med Res Opin

  • curated by Jenni Laidman
  • Clinical Essentials
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Takeaway

  • Although time-released dimethyl fumarate (DMF; Tecfidera) and fingolimod (Gilenya) showed similar reductions in relapse rates and disability progression among individuals with relapsing-remitting multiple sclerosis (RRMS) in an indirect comparison study, patient-reported quality-of-life variables showed a preference for DMF.

Why this matters

  • Head-to-head trials comparing of fingolimod and DMF have not been conducted.

Key results

  • In matching-adjusted population, annualized relapse rate of DMF at year 2 was similar to fingolimod, with a rate ratio of 0.53 vs placebo for DMF (P<.0001 and vs placebo for fingolimod>
  • There was a 31% reduction of risk for confirmed disability progression (CDP) for DMF vs placebo compard to a 24% reduction in risk for CDP for fingolimod vs placebo.
  • Patient-reported outcomes significantly favored DMF in both the EuroQoL 5-Dimensions (EQ-5D) utility score (P=.0079) and the EQ-5D visual analog score (P=.0167).

Study design

  • A matching-adjusted indirect comparison of delayed-release DMF and fingolimod accomplished by pooling individual patient data from the DMF DEFINE and CONFIRM trials and aggregate data from the fingolimod FREEDOMS and FREEDOMS II trials examining 2-y efficacy.
  • Funding: Biogen, makers of Tecfidera. 

Limitations

  • The 2-y trial duration may not sufficiently detect differences disability progression, which occurs gradually.

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