Evidence map›Paper›PMID 28129749›Full record

Trial reportBMC neurology2017

Long-term efficacy and safety of fingolimod in Japanese patients with relapsing multiple sclerosis: 3-year results of the phase 2 extension study.

Takahiko Saida, Yasuto Itoyama, Seiji Kikuchi, Qi Hao, Takayoshi Kurosawa, Kengo Ueda, Lixin Zhang Auberson, Isao Tsumiyama, Kazuo Nagato, Jun-Ichi Kira

2 registry-linked trialsAbstract readRandomized Controlled Trial
In one paragraph

Trial report in BMC neurology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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.

NCT00537082 phase2completednot on this map

A 6-month, Double-blind, Randomized, Placebo-controlled, Parallel-group, Multicenter Study Comparing Efficacy and Safety of FTY720 0.5 mg and 1.25 mg Administered Orally Once Daily in Patients With Relapsing Multiple Sclerosis

TypeinterventionalSponsorNovartisRan2007Enrolled171ConditionsMultiple SclerosisArmsFTY720, Placebo
NCT00670449 phase2completednot on this map

An Extension of the 6-month, Double-blind, Randomized, Placebo-controlled, Parallel-group, Multicenter Study Comparing Efficacy and Safety of FTY720 0.5 mg and 1.25 mg Administered Orally Once Daily in Patients With Relapsing Multiple Sclerosis

TypeinterventionalSponsorNovartisRan2008 to 2012Enrolled143ConditionsMultiple SclerosisArmsFingolimod
3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Review
  5. Article
  6. Article
  7. Review
  8. Neurological safety of fingolimod: An updated review.Clinical & experimental neuroimmunology · 2017
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Takahiko SaidaInstitute of Multiple Sclerosis Therapeutics, Nishinokyo-Kasugacho 16-44-409, Nakakyo-ku, Kyoto, 604-8453, Japan. saida_takahiko@maia.eonet.ne.jp.
Yasuto ItoyamaInternational University of Health and Welfare, 1-7-4 Momochihama, Sawara, Fukuoka City, Fukuoka, 814-0001, Japan.
Seiji KikuchiHokkaido Medical Center, National Hospital Organization, 1-1 Yamanote 5-jo 7-chome, Sapporo, 063-0005, Japan.
Qi HaoInstitute of Multiple Sclerosis Therapeutics, Nishinokyo-Kasugacho 16-44-409, Nakakyo-ku, Kyoto, 604-8453, Japan.
Takayoshi KurosawaNovartis Pharma KK, 1-23-1, Toranomon, Minato-ku, Tokyo, 105-6333, Japan.
Kengo UedaNovartis Pharma KK, 1-23-1, Toranomon, Minato-ku, Tokyo, 105-6333, Japan.
Lixin Zhang AubersonNovartis Pharma AG, Fabrikstrasse 12, 4002, Basel, Switzerland.
Isao TsumiyamaNovartis Pharma KK, 1-23-1, Toranomon, Minato-ku, Tokyo, 105-6333, Japan.
Kazuo NagatoMitsubishi Tanabe Pharma Corporation, 17-10, Nihonbashi-Koamicho, Chuo-ku Tokyo, 103-8405, Japan.
Jun-Ichi KiraDepartment of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe low level of disease activity and manageable safety profile seen with fingolimod versus placebo in a 6-month, phase 2, randomized controlled trial in Japanese patients with relapsing multiple sclerosis (MS; ClinicalTrials.gov Identifier NCT00537082) were maintained in the initial 6-month observational study extension. Here, we report long-term safety and efficacy results of the 3-year follow-up to the phase 2 study extension.

methodsThe 6-month core study was completed by 147 patients, of whom 143 entered the extension and took at least one dose of fingolimod. Those originally randomized to placebo were re-randomized to fingolimod 1.25 mg (n = 23) or 0.5 mg (n = 27). During the extension, the patients taking fingolimod 1.25 mg (n = 46) were switched to open-label fingolimod 0.5 mg, and those originally randomized to fingolimod 0.5 mg (n = 47) continued with open-label fingolimod 0.5 mg.

resultsContinuous fingolimod treatment was associated with a sustained low level of MRI and relapse activity for the duration of the extension phase; 75-100% (range across all assessment time points up to end of study) of patients remained free of Gd-enhanced T1 lesions, 88-100% remained free of new/newly enlarged T2 lesions, and 45-62% remained relapse-free. In patients who switched to the active treatment, a 79.5% decrease in annualized relapse rate (ARR; from 1.131 before switch to 0.232 6-months after switch) was observed in the first 6 months of the extension phase and thereafter remained low until the end of study (0.16-0.31 across all assessment time points after switch up to end of study). The mean number of Gd-enhanced T1 and new/newly enlarged T2 lesions decreased up to month 9 and thereafter remained low until the end of study (0.0-0.1 and 0.0-0.3, respectively, across all assessment time points after switch up to end of study). Fingolimod was generally well-tolerated and the safety profile was consistent with the core and 6-month extension. Serious adverse events were reported in 13.3% of patients during the extension study, with the range in the continuous fingolimod and placebo-fingolimod switch groups (3.7-21.7%) being similar to that reported in the core study for the placebo and fingolimod groups (5.3-20.4%).

conclusionContinuous fingolimod treatment over 36 months was associated with maintained efficacy and a manageable safety profile with no new safety signals. These results indicate that fingolimod provides long-term treatment benefit for Japanese patients with relapsing MS.

trial registrationClinicalTrials.gov NCT00670449 (April 28, 2008).

Indexed as

Outcome Assessment, Health CareAdolescentAdultFemaleFingolimod HydrochlorideFollow-Up StudiesHumansImmunosuppressive AgentsJapanMaleMiddle AgedMultiple Sclerosis, Relapsing-RemittingYoung AdultFingolimod HydrochlorideImmunosuppressive AgentsAquaporin 4FingolimodMultiple sclerosisPhase 2 study extensionRelapse

Identifiers

PMID28129749
PMCPMC5273805

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.