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Erschienen in: Journal of Neurology 8/2018

14.06.2018 | Original Communication

Two-year real-life efficacy, tolerability and safety of dimethyl fumarate in an Italian multicentre study

verfasst von: Giulia Mallucci, P. Annovazzi, S. Miante, V. Torri-Clerici, M. Matta, S. La Gioia, R. Cavarretta, V. Mantero, G. Costantini, V. D’Ambrosio, M. Zaffaroni, A. Ghezzi, P. Perini, S. Rossi, A. Bertolotto, M. R. Rottoli, M. Rovaris, R. Balgera, P. Cavalla, C. Montomoli, R. Bergamaschi

Erschienen in: Journal of Neurology | Ausgabe 8/2018

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Abstract

Background

Dimethyl-fumarate (DMF) demonstrated efficacy and safety in relapsing–remitting multiple sclerosis (MS) in randomized clinical trials.

Objectives

To track and evaluate post-market DMF profile in real-world setting.

Materials and methods

Patients receiving DMF referred to Italian MS centres were enrolled and prospectively followed, collecting demographic clinical and radiological data.

Results

Among the 735 included patients, 45.4% were naïve to disease-modifying therapies, 17.8% switched to DMF because of tolerance, 27.4% switched to DMF because of lack of efficacy, and 9.4% switched to DMF because of safety concerns. Median DMF exposure was 17 months (0–33). DMF reduced the annual relapse rate (ARR) by 63.2%. At 12 and 24 months, 85 and 76% of patients were relapse-free. NEDA-3 status after 12 months of DMF treatment was maintained by 47.5% of patients. 89 and 70% of patients at 12 and 24 months regularly continued DMF. Most frequent adverse events (AEs) were flushing (37.2%) and gastro-enteric AEs (31.1%).

Conclusion

Our post-market study corroborated that DMF is a safe and effective drug. Additionally, the study suggested that naïve patients strongly benefit from DMF and that DMF improved ARR also in patients who were horizontally switched from injectable therapies due to tolerability and efficacy issues.
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Literatur
1.
Zurück zum Zitat Fox RJ, Miller DH, Phillips JT, Hutchinson M, Havrdova E, Kita M, Yang M, Raghupathi K, Novas M, Sweetser MT, Viglietta V, Dawson KT, Investigators CS (2012) Placebo-controlled phase 3 study of oral BG-12 or glatiramer in multiple sclerosis. N Engl J Med 367:1087–1097CrossRefPubMed Fox RJ, Miller DH, Phillips JT, Hutchinson M, Havrdova E, Kita M, Yang M, Raghupathi K, Novas M, Sweetser MT, Viglietta V, Dawson KT, Investigators CS (2012) Placebo-controlled phase 3 study of oral BG-12 or glatiramer in multiple sclerosis. N Engl J Med 367:1087–1097CrossRefPubMed
2.
Zurück zum Zitat Gold R, Kappos L, Arnold DL, Bar-Or A, Giovannoni G, Selmaj K, Tornatore C, Sweetser MT, Yang M, Sheikh SI, Dawson KT, Investigators DS (2012) Placebo-controlled phase 3 study of oral BG-12 for relapsing multiple sclerosis. N Engl J Med 367:1098–1107CrossRefPubMed Gold R, Kappos L, Arnold DL, Bar-Or A, Giovannoni G, Selmaj K, Tornatore C, Sweetser MT, Yang M, Sheikh SI, Dawson KT, Investigators DS (2012) Placebo-controlled phase 3 study of oral BG-12 for relapsing multiple sclerosis. N Engl J Med 367:1098–1107CrossRefPubMed
3.
Zurück zum Zitat Gold R, Arnold DL, Bar-Or A, Hutchinson M, Kappos L, Havrdova E, MacManus DG, Yousry TA, Pozzilli C, Selmaj K, Sweetser MT, Zhang R, Yang M, Potts J, Novas M, Miller DH, Kurukulasuriya NC, Fox RJ, Phillips TJ (2017) Long-term effects of delayed-release dimethyl fumarate in multiple sclerosis: interim analysis of ENDORSE, a randomized extension study. Mult Scler 23:253–265CrossRefPubMed Gold R, Arnold DL, Bar-Or A, Hutchinson M, Kappos L, Havrdova E, MacManus DG, Yousry TA, Pozzilli C, Selmaj K, Sweetser MT, Zhang R, Yang M, Potts J, Novas M, Miller DH, Kurukulasuriya NC, Fox RJ, Phillips TJ (2017) Long-term effects of delayed-release dimethyl fumarate in multiple sclerosis: interim analysis of ENDORSE, a randomized extension study. Mult Scler 23:253–265CrossRefPubMed
4.
Zurück zum Zitat Trojano M, Tintore M, Montalban X, Hillert J, Kalincik T, Iaffaldano P, Spelman T, Sormani MP, Butzkueven H (2017) Treatment decisions in multiple sclerosis—insights from real-world observational studies. Nat Rev Neurol 13:105–118CrossRefPubMed Trojano M, Tintore M, Montalban X, Hillert J, Kalincik T, Iaffaldano P, Spelman T, Sormani MP, Butzkueven H (2017) Treatment decisions in multiple sclerosis—insights from real-world observational studies. Nat Rev Neurol 13:105–118CrossRefPubMed
5.
Zurück zum Zitat Roxburgh RH, Seaman SR, Masterman T, Hensiek AE, Sawcer SJ, Vukusic S, Achiti I, Confavreux C, Coustans M, le Page E, Edan G, McDonnell GV, Hawkins S, Trojano M, Liguori M, Cocco E, Marrosu MG, Tesser F, Leone MA, Weber A, Zipp F, Miterski B, Epplen JT, Oturai A, Sorensen PS, Celius EG, Lara NT, Montalban X, Villoslada P, Silva AM, Marta M, Leite I, Dubois B, Rubio J, Butzkueven H, Kilpatrick T, Mycko MP, Selmaj KW, Rio ME, Sa M, Salemi G, Savettieri G, Hillert J, Compston DA (2005) Multiple sclerosis severity score: using disability and disease duration to rate disease severity. Neurology 64:1144–1151CrossRefPubMed Roxburgh RH, Seaman SR, Masterman T, Hensiek AE, Sawcer SJ, Vukusic S, Achiti I, Confavreux C, Coustans M, le Page E, Edan G, McDonnell GV, Hawkins S, Trojano M, Liguori M, Cocco E, Marrosu MG, Tesser F, Leone MA, Weber A, Zipp F, Miterski B, Epplen JT, Oturai A, Sorensen PS, Celius EG, Lara NT, Montalban X, Villoslada P, Silva AM, Marta M, Leite I, Dubois B, Rubio J, Butzkueven H, Kilpatrick T, Mycko MP, Selmaj KW, Rio ME, Sa M, Salemi G, Savettieri G, Hillert J, Compston DA (2005) Multiple sclerosis severity score: using disability and disease duration to rate disease severity. Neurology 64:1144–1151CrossRefPubMed
6.
Zurück zum Zitat Giovannoni G, Tomic D, Bright JR, Havrdova E (2017) “No evident disease activity”: the use of combined assessments in the management of patients with multiple sclerosis. Mult Scler 23:1179–1187CrossRefPubMedPubMedCentral Giovannoni G, Tomic D, Bright JR, Havrdova E (2017) “No evident disease activity”: the use of combined assessments in the management of patients with multiple sclerosis. Mult Scler 23:1179–1187CrossRefPubMedPubMedCentral
7.
Zurück zum Zitat Gallo P, Van Wijmeersch B, Paradig MSG (2015) Overview of the management of relapsing-remitting multiple sclerosis and practical recommendations. Eur J Neurol 22(Suppl 2):14–21CrossRefPubMed Gallo P, Van Wijmeersch B, Paradig MSG (2015) Overview of the management of relapsing-remitting multiple sclerosis and practical recommendations. Eur J Neurol 22(Suppl 2):14–21CrossRefPubMed
8.
Zurück zum Zitat Kresa-Reahl K (2016) Clinical measures and impact on patient-reported outcomes of delayed-release dimethyl fumarate in relapsing multiple sclerosis patients after suboptimal response to glatiramer acetate: analysis of the 12-month RESPOND study. ECTRIMS, ECTRIMS Online Library, London, UK Kresa-Reahl K (2016) Clinical measures and impact on patient-reported outcomes of delayed-release dimethyl fumarate in relapsing multiple sclerosis patients after suboptimal response to glatiramer acetate: analysis of the 12-month RESPOND study. ECTRIMS, ECTRIMS Online Library, London, UK
9.
Zurück zum Zitat Miclea A, Leussink VI, Hartung HP, Gold R, Hoepner R (2016) Safety and efficacy of dimethyl fumarate in multiple sclerosis: a multi-center observational study. J Neurol 263:1626–1632CrossRefPubMed Miclea A, Leussink VI, Hartung HP, Gold R, Hoepner R (2016) Safety and efficacy of dimethyl fumarate in multiple sclerosis: a multi-center observational study. J Neurol 263:1626–1632CrossRefPubMed
10.
Zurück zum Zitat Fernandez O, Giovannoni G, Fox RJ, Gold R, Phillips JT, Potts J, Okwuokenye M, Marantz JL (2017) Efficacy and safety of delayed-release dimethyl fumarate for relapsing-remitting multiple sclerosis in prior interferon users: an integrated analysis of DEFINE and CONFIRM. Clin Ther 39:1671–1679CrossRefPubMed Fernandez O, Giovannoni G, Fox RJ, Gold R, Phillips JT, Potts J, Okwuokenye M, Marantz JL (2017) Efficacy and safety of delayed-release dimethyl fumarate for relapsing-remitting multiple sclerosis in prior interferon users: an integrated analysis of DEFINE and CONFIRM. Clin Ther 39:1671–1679CrossRefPubMed
11.
Zurück zum Zitat Havrdova E, Giovannoni G, Gold R, Fox RJ, Kappos L, Phillips JT, Okwuokenye M, Marantz JL (2017) Effect of delayed-release dimethyl fumarate on no evidence of disease activity in relapsing-remitting multiple sclerosis: integrated analysis of the phase III DEFINE and CONFIRM studies. Eur J Neurol 24:726–733CrossRefPubMedPubMedCentral Havrdova E, Giovannoni G, Gold R, Fox RJ, Kappos L, Phillips JT, Okwuokenye M, Marantz JL (2017) Effect of delayed-release dimethyl fumarate on no evidence of disease activity in relapsing-remitting multiple sclerosis: integrated analysis of the phase III DEFINE and CONFIRM studies. Eur J Neurol 24:726–733CrossRefPubMedPubMedCentral
12.
Zurück zum Zitat Berglund A (2016) Comparative analysis of adherence and persistence for delayed-release dimethyl fumarate versus interferons and glatiramer acetate—a population based study in Sweden. In: ECTRIMS. ECTRIMS Online Library, London, UK Berglund A (2016) Comparative analysis of adherence and persistence for delayed-release dimethyl fumarate versus interferons and glatiramer acetate—a population based study in Sweden. In: ECTRIMS. ECTRIMS Online Library, London, UK
13.
Zurück zum Zitat Alroughani R, Ahmed SF, Behbehani R, Al-Hashel J (2017) Effectiveness and safety of dimethyl fumarate treatment in relapsing multiple sclerosis patients: real-world evidence. Neurol Ther 6:189–196CrossRefPubMedPubMedCentral Alroughani R, Ahmed SF, Behbehani R, Al-Hashel J (2017) Effectiveness and safety of dimethyl fumarate treatment in relapsing multiple sclerosis patients: real-world evidence. Neurol Ther 6:189–196CrossRefPubMedPubMedCentral
14.
Zurück zum Zitat Fox EJ, Vasquez A, Grainger W, Ma TS, von Hehn C, Walsh J, Li J, Zambrano J (2016) Gastrointestinal tolerability of delayed-release dimethyl fumarate in a multicenter, open-label study of patients with relapsing forms of multiple sclerosis (MANAGE). Int J MS Care 18:9–18CrossRefPubMedPubMedCentral Fox EJ, Vasquez A, Grainger W, Ma TS, von Hehn C, Walsh J, Li J, Zambrano J (2016) Gastrointestinal tolerability of delayed-release dimethyl fumarate in a multicenter, open-label study of patients with relapsing forms of multiple sclerosis (MANAGE). Int J MS Care 18:9–18CrossRefPubMedPubMedCentral
15.
Zurück zum Zitat Phillips JT, Hutchinson M, Fox R, Gold R, Havrdova E (2014) Managing flushing and gastrointestinal events associated with delayed-release dimethyl fumarate: experiences of an international panel. Mult Scler Relat Disord 3:513–519CrossRefPubMed Phillips JT, Hutchinson M, Fox R, Gold R, Havrdova E (2014) Managing flushing and gastrointestinal events associated with delayed-release dimethyl fumarate: experiences of an international panel. Mult Scler Relat Disord 3:513–519CrossRefPubMed
16.
Zurück zum Zitat Theodore Phillips J, Erwin AA, Agrella S, Kremenchutzky M, Kramer JF, Darkes MJ, Kendter J, Abourjaily H, Rana J, Fox RJ (2015) Consensus management of gastrointestinal events associated with delayed-release dimethyl fumarate: a Delphi study. Neurol Ther 4:137–146CrossRefPubMedPubMedCentral Theodore Phillips J, Erwin AA, Agrella S, Kremenchutzky M, Kramer JF, Darkes MJ, Kendter J, Abourjaily H, Rana J, Fox RJ (2015) Consensus management of gastrointestinal events associated with delayed-release dimethyl fumarate: a Delphi study. Neurol Ther 4:137–146CrossRefPubMedPubMedCentral
Metadaten
Titel
Two-year real-life efficacy, tolerability and safety of dimethyl fumarate in an Italian multicentre study
verfasst von
Giulia Mallucci
P. Annovazzi
S. Miante
V. Torri-Clerici
M. Matta
S. La Gioia
R. Cavarretta
V. Mantero
G. Costantini
V. D’Ambrosio
M. Zaffaroni
A. Ghezzi
P. Perini
S. Rossi
A. Bertolotto
M. R. Rottoli
M. Rovaris
R. Balgera
P. Cavalla
C. Montomoli
R. Bergamaschi
Publikationsdatum
14.06.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
Journal of Neurology / Ausgabe 8/2018
Print ISSN: 0340-5354
Elektronische ISSN: 1432-1459
DOI
https://doi.org/10.1007/s00415-018-8916-6

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