Evidence map›Paper›PMID 24610329›Full record

ArticleNeurology2014

Fingolimod after natalizumab and the risk of short-term relapse.

Vilija G Jokubaitis, Vivien Li, Tomas Kalincik, Guillermo Izquierdo, Suzanne Hodgkinson, Raed Alroughani, Jeannette Lechner-Scott, Alessandra Lugaresi, Pierre Duquette, Marc Girard and 13 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Neurology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 60 papers.

0numbers the graph read from it
0cells of the map it votes in
60citing papers in PubMed
20.5field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

60 citing papers in PubMed, 141 citations in OpenAlex.

  1. Trial
  2. Glucocorticoid-dependent multiple sclerosis overlapping anti-NMDA receptor encephalitis: a case report and literature review update.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2024
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  12. Exit Strategies in Natalizumab-Treated RRMS at High Risk of Progressive Multifocal Leukoencephalopathy: a Multicentre Comparison Study.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2021
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

23 authors at 1 institution in 1 country.

Vilija G JokubaitisFrom the Department of Medicine (V.G.J., T.K., H.B.), Melbourne Brain Centre (RMH), The University of Melbourne; Department of Neurology (V.G.J., V.L., T.K., H.B.), Royal Melbourne Hospital, Australia; Hospital Universitario Virgen Macarena (G.I.), Seville, Spain; Liverpool Hospital (S.H.), New South Wales, Australia; Amiri Hospital (R.A.), Kuwait City, Kuwait; John Hunter Hospital (J.L.-S.), Newcastle, Australia; MS Center (A.L.), Department of Neuroscience and Imaging, University "G. d'Annunzio," Chieti, Italy; Hôpital Notre Dame (P.D., M.G.), Montreal, Canada; Brain and Mind Research Institute (M.B.), Sydney, Australia; Neuro Rive-Sud (F.G.), Hôpital Charles LeMoyne, Quebec, Canada; Department of Basic Medical Sciences (M.T.), Neuroscience and Sense Organs, University of Bari, Italy; Flinders University and Medical Centre (M.S.), Adelaide, Australia; Ospedale di Macerata (G.G.), Italy; Geelong Hospital (C.S.), Australia; Karadeniz Technical University (C.B.), Trabzon, Turkey; AORN San Giuseppe Moscati (D.L.A.S.), Avellino, Italy; Groene Hart Ziekenhuis (F.V.), Gouda, the Netherlands; Department of Neurology (J.H., H.B.), Eastern Health Victoria; Monash University (J.H., H.B.), Melbourne; and Melbourne EpiCentre (D.L.), The University of Melbourne and Melbourne Health, Australia.
Vivien Li
Tomas Kalincik
Guillermo Izquierdo
Suzanne Hodgkinson
Raed Alroughani
Jeannette Lechner-Scott
Alessandra Lugaresi
Pierre Duquette
Marc Girard
Michael Barnett
Francois Grand'Maison
Maria Trojano
Mark Slee
Giorgio Giuliani
Cameron Shaw
Cavit Boz
Daniele L A Spitaleri
Freek Verheul
Jodi Haartsen
Danny Liew
Helmut Butzkueven
MSBase Study Group
Eastern Health · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo determine early risk of relapse after switch from natalizumab to fingolimod; to compare the switch experience to that in patients switching from interferon-β/glatiramer acetate (IFN-β/GA) and those previously treatment naive; and to determine predictors of time to first relapse on fingolimod.

methodsData were obtained from the MSBase Registry. Relapse rates (RRs) for each patient group were compared using adjusted negative binomial regression. Survival analyses coupled with adjusted Cox regression were used to model predictors of time to first relapse on fingolimod.

resultsA total of 536 patients (natalizumab-fingolimod [n = 89]; IFN-β/GA-fingolimod [n = 350]; naive-fingolimod [n = 97]) were followed up for a median 10 months. In the natalizumab-fingolimod group, there was a small increase in RR on fingolimod (annualized RR [ARR] 0.38) relative to natalizumab (ARR 0.26; p = 0.002). RRs were generally low across all patient groups in the first 9 months on fingolimod (RR 0.001-0.13). However, 30% of patients with disease activity on natalizumab relapsed within the first 6 months on fingolimod. Independent predictors of time to first relapse on fingolimod were the number of relapses in the prior 6 months (hazard ratio [HR] 1.59 per relapse; p = 0.002) and a gap in treatment of 2-4 months compared to no gap (HR 2.10; p = 0.041).

conclusionsRRs after switch to fingolimod were low in all patient groups. The strongest predictor of relapse on fingolimod was prior relapse activity. Based on our data, we recommend a maximum 2-month treatment gap for switches to fingolimod to decrease the hazard of relapse. CLASSIFICATION OF EVIDENCE: This study provides Class IV evidence that RRs are not higher in patients with multiple sclerosis switching to fingolimod from natalizumab compared to those patients switching to fingolimod from other therapies.

Indexed as

AdultAntibodies, Monoclonal, HumanizedFemaleFingolimod HydrochlorideHumansImmunologic FactorsImmunosuppressive AgentsInterferon-betaMaleMiddle AgedMultiple Sclerosis, Relapsing-RemittingNatalizumabPropylene GlycolsRisk FactorsSecondary PreventionSphingosineAntibodies, Monoclonal, HumanizedFingolimod HydrochlorideImmunologic FactorsImmunosuppressive AgentsInterferon-betaNatalizumabPropylene GlycolsSphingosine

Identifiers

PMID24610329
PMCPMC4001200
OpenAlexW1997159649

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.