Evidence map›Paper›PMID 33510948›Full record

ArticleNeurology. Clinical practice2020

Effect of switching from natalizumab to moderate- vs high-efficacy DMT in clinical practice.

Carrie M Hersh, Haleigh Harris, Devon Conway, Le H Hua

Abstract read
In one paragraph

Article in Neurology. Clinical practice, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing 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.

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

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

  1. Pooled it
  2. Real-world effectiveness and safety of ofatumumab in relapsing-remitting multiple sclerosis: Insights from naïve and switch patients.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2025
    Article
  3. Article
  4. Impact of Age on Switching or Stopping Disease Modifying Therapies in Multiple Sclerosis.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2025
    Review
  5. Article
  6. Article
  7. Review
  8. Updates and advances in multiple sclerosis neurotherapeutics.Neurodegenerative disease management · 2023
    Review
  9. 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

4 authors.

Carrie M HershLou Ruvo Center for Brain Health (CMH, HH, LHH), Cleveland Clinic, Las Vegas, NV; and Mellen Center for Multiple Sclerosis Treatment and Research (DC), Cleveland Clinic, Cleveland, OH.
Haleigh HarrisLou Ruvo Center for Brain Health (CMH, HH, LHH), Cleveland Clinic, Las Vegas, NV; and Mellen Center for Multiple Sclerosis Treatment and Research (DC), Cleveland Clinic, Cleveland, OH.
Devon ConwayLou Ruvo Center for Brain Health (CMH, HH, LHH), Cleveland Clinic, Las Vegas, NV; and Mellen Center for Multiple Sclerosis Treatment and Research (DC), Cleveland Clinic, Cleveland, OH.
Le H HuaLou Ruvo Center for Brain Health (CMH, HH, LHH), Cleveland Clinic, Las Vegas, NV; and Mellen Center for Multiple Sclerosis Treatment and Research (DC), Cleveland Clinic, Cleveland, OH.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo assess the real-world comparative effectiveness of switching from natalizumab (NTZ) to a moderate-efficacy (Mod) disease-modifying therapy (DMT) vs high-efficacy therapy (HET) in patients with multiple sclerosis (MS).

methodsPatients discontinuing NTZ at two MS centers (n = 556) who switched to Mod DMT (n = 270) vs HET (n = 130) were assessed using propensity score (PS) weighting. PS model covariates included demographics and baseline clinical and MRI characteristics. All outcomes were reported as Mod DMT vs HET.

resultsOf the patients included in the study, 48.6% switched to Mod DMT (dimethyl fumarate, n = 130; fingolimod, n = 140) vs 23.4% who switched to HET (ocrelizumab, n = 106; rituximab, n = 17; alemtuzumab, n = 7). Within the first 6 months post-NTZ, switchers to Mod DMT experienced comparable relapses (odds ratio [OR] = 1.36, 95% confidence interval [CI] [0.72-1.66],

conclusionPatients switching from NTZ to Mod DMT vs HET were at relatively increased risk of disease activity within the first 6 months of NTZ withdrawal that was sustained at 24 months, yielding greater disability progression.

Identifiers

PMID33510948
PMCPMC7837445

What OpenQuestion holds

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LicenceCC BY-NC-ND
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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.