Evidence map›Paper›PMID 32719903›Full record

Observational studyNeurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology2021

Clinical effectiveness of reduced fingolimod dose in relapsing remitting multiple sclerosis-a Portuguese cohort.

Joana Ramos-Lopes, Sónia Batista, Pedro Barradas, Isabel Campelo, Inês Correia, Carla Nunes, Carmo Macário, Lívia Sousa

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.1field-weighted citation impact, top 51% 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

3 citing papers in PubMed, 4 citations in OpenAlex.

  1. Review
  2. Review
  3. Article
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

8 authors at 1 institution in 1 country.

Joana Ramos-LopesDepartment of Neurology, Centro Hospitalar e Universitário de Coimbra, Praceta Professor Mota Pinto, 3000-075, Coimbra, Portugal. joanaflopes6@gmail.com.ORCID http://orcid.org/0000-0001-8034-2235
Sónia BatistaDepartment of Neurology, Centro Hospitalar e Universitário de Coimbra, Praceta Professor Mota Pinto, 3000-075, Coimbra, Portugal.
Pedro BarradasNeuroradiology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
Isabel CampeloPharmaceutical Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
Inês CorreiaDepartment of Neurology, Centro Hospitalar e Universitário de Coimbra, Praceta Professor Mota Pinto, 3000-075, Coimbra, Portugal.
Carla NunesDepartment of Neurology, Centro Hospitalar e Universitário de Coimbra, Praceta Professor Mota Pinto, 3000-075, Coimbra, Portugal.
Carmo MacárioDepartment of Neurology, Centro Hospitalar e Universitário de Coimbra, Praceta Professor Mota Pinto, 3000-075, Coimbra, Portugal.
Lívia SousaDepartment of Neurology, Centro Hospitalar e Universitário de Coimbra, Praceta Professor Mota Pinto, 3000-075, Coimbra, Portugal.
Hospitais da Universidade de Coimbra · PT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFingolimod is an oral daily treatment for relapsing remitting multiple sclerosis (RRMS). A decrease in lymphocytes count is a common side effect, whereby clinicians occasionally propose a reduced dose rather than its discontinuation. However, current data on the effectiveness of these regimens are scarce and contradictory. Our objective was to investigate if the fingolimod effectiveness is maintained with reduction in dosing frequency.

methodsRetrospective and observational study of RRMS patients taking fingolimod-nondaily (FTY-ND) for at least 6 months. Propensity score-based matching was performed to select patients taking daily dose (FTY-ED) with comparable baseline characteristics: age, sex, disease duration, annualized relapse rate (ARR), and expanded disability status scale (EDSS). Afterwards, clinical and laboratorial assessment was evaluated in both groups.

resultsThirty-six patients were included in each group (FTY-ED vs. FTY-ND). Decrease in lymphocytes count was the main reason for switching to FTY-ND (88.9%). Previous treatment with natalizumab was inversely associated with risk of reducing dose (OR 0.253, 95%CI = 0.08-0.807, p = 0.016). There were no significant differences in clinical disease activity between patients FTY-ED vs. FTY-ND: mean ARR 0.4 vs. 0.3 (p = 0.247), median EDSS 2.0 vs. 2.0 (p = 0.687), and proportion of patients with EDSS increase 8.3% vs. 13.9% (p = 0.453). FTY-ND was overall well tolerated and was associated with an increase in the mean lymphocytes count (362 ± 103 cells/mm

conclusionThese data suggest that the effectiveness of FTY is maintained despite the reduction of the dose, minimizing the most common adverse events. These findings warrant further confirmation, ideally with randomized clinical trials.

Indexed as

Multiple SclerosisMultiple Sclerosis, Relapsing-RemittingFingolimod HydrochlorideHumansImmunosuppressive AgentsNatalizumabPortugalRetrospective StudiesTreatment OutcomeFingolimod HydrochlorideImmunosuppressive AgentsNatalizumabAdverse effectsFingolimodLymphopeniaMultiple sclerosisReduced dose

Identifiers

PMID32719903
OpenAlexW3045726045

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.