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Lateral and escalation therapy in relapsing-remitting multiple sclerosis: a comparative study

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Abstract

Performing a therapeutic switch in MS is still a matter of debate. Objective of our study is to compare switching to another first-line therapy with switching to a second-line therapy in persons with relapsing-remitting multiple sclerosis (pwRRMS). A retrospective analysis of data prospectively collected was performed. PwRRMS experiencing on-treatment disease activity were included. No clinical relapse, no sustained disability progression by the Expanded Disability Status Scale (EDSS), and no radiological activity (new T2 and/or gadolinium-enhanced brain lesions) were used as indicators of no disease activity (NEDA 3). Time to reach the first relapse after switch and time to reach an EDSS of 4.0 were also evaluated. Ninety-one pwRRMS were enrolled. Forty-eight (52.7 %) were on lateral switch, and 43 (47.3 %) on escalation switch. At baseline, the two groups differed for T2 and T1 brain lesions number (higher in the escalation group, p < 0.005). The proportion of pwRRMS who were NEDA 3 after 24 months from the switch was similar in the two groups (20.8 % in lateral group and 18.6 % in escalation group). No difference in timing to reach the first relapse after switch and an EDSS of 4.0 were found. Therefore, in selected pwRRMS, lateral and escalation strategies showed similar efficacy in delaying MS progression.

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Authors and Affiliations

  1. Multiple Sclerosis Center, Policlinico G. Rodolico, Via Santa Sofia, 78, Catania, 95123, Italy

    Emanuele D’Amico, Carmela Leone, Aurora Zanghì, Salvatore Lo Fermo & Francesco Patti

Authors
  1. Emanuele D’Amico
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  2. Carmela Leone
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  3. Aurora Zanghì
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  4. Salvatore Lo Fermo
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  5. Francesco Patti
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Correspondence to Francesco Patti.

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Conflicts of interest

Dr. Patti served on the scientific advisory board for Teva, Biogen-Idec, Bayer-Schering, Novartis, and has received honoraria as a speaker for Teva, Biogen, Merck-Serono, Bayer-Schering, Genzyme/Sanofi, and Novartis. Dr. D’Amico received funding travel by Teva, Biogen, Merck-Serono, Bayer-Schering, Genzyme/Sanofi, Novartis. The other authors have nothing to disclose.

Ethical standards

Manuscript complains with ethical standards; it has been approved by ethics committee and has, therefore, been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

All the patients have given their informed consent prior to their inclusion in the study. Details that might disclose their identity have been omitted.

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D’Amico, E., Leone, C., Zanghì, A. et al. Lateral and escalation therapy in relapsing-remitting multiple sclerosis: a comparative study. J Neurol 263, 1802–1809 (2016). https://doi.org/10.1007/s00415-016-8207-z

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  • DOI: https://doi.org/10.1007/s00415-016-8207-z

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