ArticleAnnals of clinical and translational neurology2015
Comparative efficacy of switching to natalizumab in active multiple sclerosis.
Article in Annals of clinical and translational neurology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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.
Who cites it
27 citing papers in PubMed, 1 synthesis or guideline pooled it, 63 citations in OpenAlex.
- Interferons-beta versus glatiramer acetate for relapsing-remitting multiple sclerosis.The Cochrane database of systematic reviews · 2016Pooled it
- Sex and gender as contributors to brain pathophysiology, clinical course, and therapeutic response in multiple sclerosis.Frontiers in behavioral neuroscience · 2026Review
- Effectiveness of escalation versus early high-efficacy therapies on progression independent of relapse activity in multiple sclerosis: a Danish nationwide study.BMJ neurology open · 2026Article
- Cost-consequence analysis of early vs. delayed natalizumab use in highly active relapsing-remitting multiple sclerosis: a simulation study.Journal of neurology · 2025Article
- Comparative Effectiveness of Natalizumab, Fingolimod, and Injectable Therapies in Pediatric-Onset Multiple Sclerosis: A Registry-Based Study.Neurology · 2024Article
- Handling related publications reporting real-world evidence in network meta-analysis: a case study in multiple sclerosis.Journal of comparative effectiveness research · 2023Article
- Variability of the response to immunotherapy among subgroups of patients with multiple sclerosis.European journal of neurology · 2023Article
- Switching to second line MS disease-modifying therapies is associated with decreased relapse rate.Frontiers in neurology · 2023Article
- High-Efficacy Therapies for Treatment-Naïve Individuals with Relapsing-Remitting Multiple Sclerosis.CNS drugs · 2022Review
- Comparative Effectiveness and Cost-Effectiveness of Natalizumab and Fingolimod in Patients with Inadequate Response to Disease-Modifying Therapies in Relapsing-Remitting Multiple Sclerosis in the United Kingdom.PharmacoEconomics · 2022Article
- Early Aggressive Treatment Approaches for Multiple Sclerosis.Current treatment options in neurology · 2021Review
- Multiple Sclerosis Therapy Consensus Group (MSTCG): position statement on disease-modifying therapies for multiple sclerosis (white paper).Therapeutic advances in neurological disorders · 2021Review
- Cost-effectiveness analysis of escalating to natalizumab or switching among immunomodulators in relapsing-remitting multiple sclerosis in Italy.BMC health services research · 2019Article
- Treatment escalation leads to fewer relapses compared with switching to another moderately effective therapy.Journal of neurology · 2019Observational
- Eosinophilic Pneumonia Associated With Natalizumab In A Patient With Multiple Sclerosis: A Case Report And Literature Review.Therapeutics and clinical risk management · 2019Article
- Real-world effectiveness of natalizumab and fingolimod compared with self-injectable drugs in non-responders and in treatment-naïve patients with multiple sclerosis.Journal of neurology · 2017Article
- Treatment decisions in multiple sclerosis - insights from real-world observational studies.Nature reviews. Neurology · 2017Review
- Health care resource utilization before and after natalizumab initiation among patients with multiple sclerosis in Germany.ClinicoEconomics and outcomes research : CEOR · 2017Article
- Lateral and escalation therapy in relapsing-remitting multiple sclerosis: a comparative study.Journal of neurology · 2016Article
- The importance of collecting structured clinical information on multiple sclerosis.BMC medicine · 2016Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
22 authors at 16 institutions in 8 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo compare treatment efficacy and persistence in patients who switched to natalizumab versus those who switched between glatiramer acetate (GA) and interferon-beta (IFNβ) after an on-treatment relapse on IFNβ or GA using propensity score matched real-world datasets.
methodsPatients included were registered in MSBase or the TYSABRI Observational Program (TOP), had relapsed on IFNβ or GA within 12 months prior to switching to another therapy, and had initiated natalizumab or IFNβ/GA treatment ≤6 months after discontinuing prior therapy. Covariates were balanced across post switch treatment groups by propensity score matching at treatment initiation. Relapse, persistence, and disability measures were compared between matched treatment arms in the total population (n = 869/group) and in subgroups defined by prior treatment history (IFNβ only [n = 578/group], GA only [n = 165/group], or both IFNβ and GA [n = 176/group]).
resultsCompared to switching between IFNβ and GA, switching to natalizumab reduced annualized relapse rate in year one by 65-75%, the risk of first relapse by 53-82% (mean follow-up 1.7-2.2 years) and treatment discontinuation events by 48-65% (all P ≤ 0.001). In the total population, switching to natalizumab reduced the risk of confirmed disability progression by 26% (P = 0.036) and decreased the total disability burden by 1.54 EDSS-years (P < 0.0001) over the first 24 months post switch.
interpretationUsing large, real-world, propensity-matched datasets we demonstrate that after a relapse on IFNβ or GA, switching to natalizumab (rather than between IFNβ and GA) led to superior outcomes for patients in all measures assessed. Results were consistent regardless of the prior treatment identity.
Identifiers
What OpenQuestion holds
Registered trials
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.