Evidence map›Paper›PMID 30446966›Full record

ArticleJournal of neurology2019

Efficacy and safety of alemtuzumab versus fingolimod in RRMS after natalizumab cessation.

Steffen Pfeuffer, Rene Schmidt, Frederike Anne Straeten, Refik Pul, Christoph Kleinschnitz, Marinus Wieshuber, De-Hyung Lee, Ralf A Linker, Sebastian Doerck, Vera Straeten and 13 more

Abstract readComparative StudyMulticenter Study
PubMed Publisher
In one paragraph

Article in Journal of neurology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 1 pooled it
2.7field-weighted citation impact, top 10% 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

11 citing papers in PubMed, 1 synthesis or guideline pooled it, 23 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. The Art of Sequencing Disease-Modifying Therapies in Multiple Sclerosis.Neurology(R) neuroimmunology & neuroinflammation · 2026
    Review
  4. Observational
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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

23 authors at 9 institutions in 1 country.

Steffen PfeufferDepartment of Neurology and Institute for Translational Neurology, University Hospital Muenster, University of Muenster, Albert-Schweitzer-Campus 1, 48149, Muenster, Germany.ORCID http://orcid.org/0000-0001-5171-4845
Rene SchmidtInstitute of Biostatistics and Clinical Research, University of Muenster, Muenster, Germany.
Frederike Anne StraetenDepartment of Neurology and Institute for Translational Neurology, University Hospital Muenster, University of Muenster, Albert-Schweitzer-Campus 1, 48149, Muenster, Germany.
Refik PulDepartment of Neurology, University Duisburg-Essen, Duisburg, Germany.
Christoph KleinschnitzDepartment of Neurology, University Duisburg-Essen, Duisburg, Germany.
Marinus WieshuberDepartment of Neurology, Friedrich-Alexander-University, Erlangen-Nuremberg, Germany.
De-Hyung LeeDepartment of Neurology, Friedrich-Alexander-University, Erlangen-Nuremberg, Germany.
Ralf A LinkerDepartment of Neurology, Friedrich-Alexander-University, Erlangen-Nuremberg, Germany.
Sebastian DoerckDepartment of Neurology, University of Wuerzburg, Wuerzburg, Germany.
Vera StraetenDepartment of Neurology, Johannes-Wesling-Hospital Minden, Minden, Germany.
Susanne WindhagenDepartment of Neurology, Clinics Osnabrueck, Osnabrueck, Germany.
Marc PawlitzkiDepartment of Neurology, University Medical Center Magdeburg, Magdeburg, Germany.
Christoph AufenbergDepartment of Neurology, Herz-Jesu-Hospital Muenster-Hiltrup, Muenster, Germany.
Michael LangCenter for Neurology, Ulm, Germany.
Christian EienbroekerDepartment of Neurology, University of Giessen-Marburg, Marburg, Germany.
Björn TackenbergDepartment of Neurology, University of Giessen-Marburg, Marburg, Germany.
Volker LimmrothDepartment of Neurology, Cologne General Hospitals, University of Cologne, Cologne, Germany.
Brigitte WildemannDepartment of Neurology, University Hospital of Heidelberg, Heidelberg, Germany.
Jürgen HaasDepartment of Neurology, University Hospital of Heidelberg, Heidelberg, Germany.
Luisa KlotzDepartment of Neurology and Institute for Translational Neurology, University Hospital Muenster, University of Muenster, Albert-Schweitzer-Campus 1, 48149, Muenster, Germany.
Heinz WiendlDepartment of Neurology and Institute for Translational Neurology, University Hospital Muenster, University of Muenster, Albert-Schweitzer-Campus 1, 48149, Muenster, Germany.
Tobias RuckDepartment of Neurology and Institute for Translational Neurology, University Hospital Muenster, University of Muenster, Albert-Schweitzer-Campus 1, 48149, Muenster, Germany.
Sven G MeuthDepartment of Neurology and Institute for Translational Neurology, University Hospital Muenster, University of Muenster, Albert-Schweitzer-Campus 1, 48149, Muenster, Germany. sven.meuth@ukmuenster.de.
University Hospital Münster · DEFriedrich-Alexander-Universität Erlangen-Nürnberg · DEHeidelberg University · DEJustus-Liebig-Universität Gießen · DEUniversity of Duisburg-Essen · DEJohannes Wesling Klinikum Minden · DEUniversity Hospital Magdeburg · DEUniversity of Cologne · DEUniversity of Würzburg · DE

Funding

Competence Network Multiple Sclerosis 01GI1603DSanofi Genzyme ALAIN01
6 · The paper itself

Abstract

backgroundNatalizumab (NTZ) was the first approved monoclonal antibody for the treatment of relapsing-remitting multiple sclerosis (RRMS). Despite proven and sustained efficacy, its use is limited by the risk of progressive multifocal leukoencephalopathy (PML). Moreover, some patients show ongoing disease activity under NTZ, requiring a switch to another disease-modifying treatment (DMT). However, evidence regarding the optimal DMT for treatment of active RRMS after NTZ-cessation is still scarce.

objectiveTo evaluate efficacy and safety outcomes of ALEM vs FTY treatment after cessation of NTZ.

methodsWe retrospectively identified patients at 12 German neurology centers and analyzed risks for disease activity, adverse events, disability progression, and treatment discontinuation.

results195 patients were identified and 144 underwent final analysis (FTY: 101; ALEM: 42). The hazard ratio for clinical relapses was 2.24 favoring ALEM (95% CI 1.12-4.50; p = 0.015). The hazard ratio for adverse events was 7.78 (95% CI 1.04-57.95; p = 0.006) and 2.41 for MRI progression (95% CI 1.26-4.60; p = 0.004). The odds ratio for disability progression after 12 months was 4.84 (95% CI 1.74-13.47, p = 0.003). Differences remained after adjusting for possible confounders (e.g., age, sex, baseline disability, NTZ treatment duration, washout time).

conclusionOur findings indicated particular advantages of ALEM compared to FTY in patients stopping NTZ.

Indexed as

AdultAlemtuzumabDisease ProgressionFemaleFingolimod HydrochlorideHumansImmunologic FactorsImmunomodulationMaleMiddle AgedMultiple Sclerosis, Relapsing-RemittingNatalizumabRetrospective StudiesTreatment OutcomeAlemtuzumabFingolimod HydrochlorideImmunologic FactorsNatalizumabAlemtuzumabFingolimodImmunomodulatory therapyNatalizumabProgressive multifocal leukoencephalopathyRemitting-relapsing multiple sclerosis

Identifiers

PMID30446966
OpenAlexW2901480767

What OpenQuestion holds

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Registered trials

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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.