Fatigue Improvement after Switching Multiple Sclerosis Treatment from Interferon-β to Glatiramer Acetate in Clinical Practice

Meca-Lallana, José; Hernández, Luis; Caminero, Ana B.; Girón, J.; Cano-Orgaz, Antonio; Carcelén‐Gadea, María; Muñoz, Delicias; Durán-Ferreras, Eduardo; Martı́n-Hernández, Javier; Rosa, Rainel Sánchez-de la

doi:10.1159/000447630

Cited by 8 publications

(9 citation statements)

References 39 publications

(67 reference statements)

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“…Interferon therapy in MS has been associated with fatigue, 21 and changing from interferon to glatiramer acetate has already been associated with improvement of fatigue and work/activity impairment and quality of life, respectively. 22,23 Indeed, the FSS score in pre-treated patients (many of them previous IFN users) in TAURUS-MS I improved under teriflunomide. Patient satisfaction, as measured with the TSQM, improved efficacy and convenience domains in pre-treated patients, the latter being in line with the general finding that oral medications are more convenient than injectables.…”

Section: Discussionmentioning

confidence: 99%

Teriflunomide in relapsing-remitting multiple sclerosis: outcomes by age and pre-treatment status

Kallmann

Ries²,

Kullmann

et al. 2021

Ther Adv Neurol Disord

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Background and aims: To investigate effectiveness and safety of teriflunomide (14 mg once daily) in association with age and pre-treatment in unselected MS patients. Methods: Prespecified analysis of a non-interventional, prospective, real-world study in Germany. Results: A total of 558 (49.5%) patients were above 45 years old, and 593 patients (52.6%) had been pre-treated within 6 months prior to teriflunomide. Baseline Expanded Disability Status Scale (EDSS) was higher with older age, with lower number of relapses. Relapse rate decreased in all age groups, and in both treatment-naïve (0.82 ± 0.73 at baseline; 0.25 ± 0.55 under teriflunomide) and pre-treated (from 0.48 ± 0.76; 0.22 ± 0.50) patients after 12 months compared with the year before teriflunomide initiation. EDSS remained stable in patients of all age groups as well as in therapy-naïve and pre-treated patients over 24 months. The percentage of patients with adverse events (AEs) ranged between 29.2% (age group >25–35) and 38.9% (age group >55–65), with an increased discontinuation rate (most commonly due to diarrhoea, alopecia and nausea) in the higher age groups. AE rates were lower in pre-treated compared with treatment-naïve patients. Conclusion: Overall, patients of all age groups including older patients, and irrespective of pre-treatment, benefit from teriflunomide treatment in routine clinical practice. Registration: BfArM public study database number 2075.

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Section: Discussionmentioning

confidence: 99%

Teriflunomide in relapsing-remitting multiple sclerosis: outcomes by age and pre-treatment status

Kallmann

Ries²,

Kullmann

et al. 2021

Ther Adv Neurol Disord

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Section: Introductionmentioning

confidence: 99%

“…29 For example, beta-interferons are possibly associated with fatigue, while a switch to other medications, such as glatiramer acetate or fingolimod, has been shown to improve symptoms. 30,31 Fingolimod (FTY720, Gilenya V R ) is an oral, oncedaily immunomodulatory drug approved for the treatment of relapsing-remitting MS (RRMS) in the United States, Europe, and other regions. Fingolimod's mode of action is characterized by sequestration of lymphocytes in the lymph nodes.…”

Section: Introductionmentioning

confidence: 99%

A randomized study to evaluate the effect of exercise on fatigue in people with relapsing–remitting multiple sclerosis treated with fingolimod

Mäurer

Schuh

Seibert

et al. 2018

Multiple Sclerosis Journal - Experimental, Translational and Cl

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BackgroundFatigue is a major symptom of multiple sclerosis (MS) in patients, and it has been shown to improve with physical exercise. Although fingolimod might lessen fatigue, it is unclear how patients treated with fingolimod react to physical activity regarding fatigue.ObjectiveThis study evaluated the effect of an exercise intervention on fatigue in relapsing–remitting MS patients receiving fingolimod.MethodsPeople with MS (PwMS) were randomized to either a structured internet-based exercise program (e-training) or no e-training intervention. The primary endpoint was the change in the Modified Fatigue Impact Scale (mFIS) after six months.ResultsThe primary analysis showed no statistically significant difference between groups in the mFIS change. Subgroup analyses revealed a beneficial effect of physical exercise for PwMS with low aerobic capacity and with low aerobic capacity plus more severe fatigue. The incidence of adverse events was similar in both groups. No cardiovascular events were reported. The majority of PwMS were relapse free.ConclusionPhysical exercise benefits on fatigue may depend on the physical capacity of the patient and requires individualized training. Consistent with previous studies, these results suggest that physical exercise generally does not impose a risk and that this holds true also for patients receiving fingolimod.Trial registration: ClinicalTrials.gov, NCT01490840.

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“…This potential link should be further evaluated. 33–35 Future prospective studies should be designed to further confirm these associations and potentially elucidate the mechanism(s) by which fatigue may predict MS disease worsening.…”

Section: Discussionmentioning

confidence: 99%

Fatigue at enrollment predicts EDSS worsening in the New York State Multiple Sclerosis Consortium

Vaughn¹,

Kavak²,

Dwyer

et al. 2018

Mult Scler

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Background: Fatigue is one of the most common and distressing symptoms among persons with multiple sclerosis (pwMS). Objective: The aim of this study is to evaluate fatigue as a predictor for disease worsening among pwMS. Methods: In this retrospective cohort study of New York State MS Consortium (NYSMSC) registry, MS patients reporting moderate-to-severe fatigue at study enrollment ( n = 2714) were frequency matched to less-fatigued subjects ( n = 2714) on age, baseline Kurtzke Expanded Disability Status Scale (EDSS), disease duration, and MS phenotype. Change from baseline patient-reported outcomes (PROs), as measured by LIFEware™, categorized participants into two groups: those with stable/improved outcomes and those who worsened. In a subgroup of patients with longitudinal data ( n = 1951), sustained EDSS worsening was analyzed using Cox proportional hazards modeling to explore the effect of fatigue. Results: The median survival time from study enrollment to sustained EDSS worsening was 8.7 years (CI: 7.2–10.1). Participants who reported fatigue at baseline were more likely to experience sustained EDSS worsening during follow-up (HR: 1.4, 95% CI: 1.2–1.7). Patients who were fatigued at baseline were also more likely to report worsening psychosocial limitations (all ps ⩽ 0.01). Conclusion: In addition to being a common symptom of MS, severe fatigue was a significant predictor for EDSS worsening in the NYSMSC.

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Fatigue Improvement after Switching Multiple Sclerosis Treatment from Interferon-β to Glatiramer Acetate in Clinical Practice

Cited by 8 publications

References 39 publications

Teriflunomide in relapsing-remitting multiple sclerosis: outcomes by age and pre-treatment status

Teriflunomide in relapsing-remitting multiple sclerosis: outcomes by age and pre-treatment status

A randomized study to evaluate the effect of exercise on fatigue in people with relapsing–remitting multiple sclerosis treated with fingolimod

Fatigue at enrollment predicts EDSS worsening in the New York State Multiple Sclerosis Consortium

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