Evidence map›Paper›PMID 35303292›Full record

ArticleClinical drug investigation2022

Multiple Sclerosis Relapses Following Cessation of Fingolimod.

Charles B Malpas, Izanne Roos, Sifat Sharmin, Katherine Buzzard, Olga Skibina, Helmut Butzkueven, Ludwig Kappos, Francesco Patti, Raed Alroughani, Dana Horakova and 8 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical drug investigation, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–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

8 citing papers in PubMed.

  1. Observational
  2. Article
  3. Article
  4. Review
  5. Review
  6. Article
  7. Article
  8. 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

18 authors.

Charles B MalpasDepartment of Medicine, CORe, University of Melbourne, Melbourne, VIC, Australia.
Izanne RoosDepartment of Medicine, CORe, University of Melbourne, Melbourne, VIC, Australia.
Sifat SharminDepartment of Medicine, CORe, University of Melbourne, Melbourne, VIC, Australia.
Katherine BuzzardBox Hill Hospital, Melbourne, VIC, Australia.
Olga SkibinaBox Hill Hospital, Melbourne, VIC, Australia.
Helmut ButzkuevenCentral Clinical School, Monash University, Melbourne, VIC, Australia.
Ludwig KapposDepartments of Medicine and Clinical Research, Neurologic Clinic and Policlinic, University Hospital and University of Basel, Basel, Switzerland.
Francesco PattiGF Ingrassia Department, University of Catania, Catania, Italy.
Raed AlroughaniDivision of Neurology, Department of Medicine, Amiri Hospital, Sharq, Kuwait.
Dana HorakovaDepartment of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic.
Eva Kubala HavrdovaDepartment of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic.
Guillermo IzquierdoHospital Universitario Virgen Macarena, Sevilla, Spain.
Sara EichauHospital Universitario Virgen Macarena, Sevilla, Spain.
Suzanne HodgkinsonLiverpool Hospital, Sydney, NSW, Australia.
Pierre GrammondCISSS ChaudiËre-Appalache, Levis, QC, Canada.
Jeannette Lechner-ScottSchool of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia.
Tomas KalincikDepartment of Medicine, CORe, University of Melbourne, Melbourne, VIC, Australia. tomas.kalincik@unimelb.edu.au.ORCID http://orcid.org/0000-0003-3778-1376
MSBase Study Group

Funding

National Health and Medical Research Council 1080518National Health and Medical Research Council 1129189National Health and Medical Research Council 1140766
6 · The paper itself

Abstract

backgroundThere is growing interest in the issue of disease reactivation in multiple sclerosis following fingolimod cessation. Relatively little is known about modifiers of the risk of post-cessation relapse, including the delay to commencement of new therapy and prior disease activity.

objectiveWe aimed to determine the rate of relapse following cessation of fingolimod and to identify predictors of relapse following cessation.

methodsData were extracted from the MSBase registry in March 2019. Inclusion criteria were (a) clinically definite relapsing multiple sclerosis, (b) treatment with fingolimod for ≥ 12 months, (c) follow-up after cessation for ≥ 12 months, and (d) at least one Expanded Disability Status Scale score recorded in the 12 months before cessation.

resultsA total of 685 patients were identified who met criteria. The mean annualised relapse rate was 1.71 (95% CI 1.59, 1.85) in the year prior to fingolimod, 0.50 (95% CI 0.44, 0.55) on fingolimod and 0.43 (95% CI 0.38, 0.49) after fingolimod. Of these, 218 (32%) patients experienced a relapse in the first 12 months. Predictors of a higher relapse rate in the first year were: younger age at fingolimod cessation, higher relapse rate in the year prior to cessation, delaying commencement of new therapy and switching to low-efficacy therapy.

conclusionsDisease reactivation following fingolimod cessation is more common in younger patients, those with greater disease activity prior to cessation and in those who switch to a low-efficacy therapy.

Indexed as

Multiple SclerosisMultiple Sclerosis, Relapsing-RemittingFingolimod HydrochlorideHumansImmunosuppressive AgentsRecurrenceFingolimod HydrochlorideImmunosuppressive Agents

Identifiers

PMID35303292
PMCPMC8989797

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.