MS Patients Seen to Safely Switch to Oral Drugs from Injectable Oral Therapies

Stable multiple sclerosis (MS) patients do not appear to be at any increased risk of disease reactivation while switching to oral therapy following treatment with injectable interferon-β/glatiramer acetate (IFNβ/GA), a study reports.

Recently published in the European Journal of Neurology, the Australian study was titled “Risk of early relapse following the switch from injectables to oral agents for multiple sclerosis.“

Earlier research had raised concerns that people switching to the oral immunomodulating drug fingolimod (Gilenya) could be at increased risk of MS relapse, but little data has been collected on the six-month period following a switch in treatments.

The research team from the Royal Melbourne Hospital compared 396 MS patients moving from IFNβ/GA to oral drugs to an equal number of MS patients who remained on the injectable treatment. The study analyzed data from patients who had been stable on the IFNβ/GA treatment for at least the previous 12 months.

The team analyzed the frequency of relapse and disability progression, and found no differences between the two groups, either in the rate of relapse or in disease progression. Relapses in both groups were relatively rare, with 7.3 percent of the switchers experiencing a relapse, compared to 6.6 percent of patients remaining on injectable treatment.

Researchers also analyzed patients divided into subgroups based on the type of oral treatment given. Most switched to fingolimod (71.2 percent), but 16.2 percent moved to dimethyl fumarate, and the remaining to teriflunomide. Again, the researchers could not detect any differences in relapse rate among patients in these three groups. The time of washout of IFNβ/GA treatment also was not linked to an increased relapse risk or disease progression.

Injectable MS drugs are associated with a range of problems, including poor treatment adherence due to side effects, which can increase the risk of relapse. Oral treatment options now available may better serve this population. The study concluded that switching to oral therapy was not associated with any negative outcomes during the six months following a treatment switch in stable patients. Nevertheless, more research is needed to evaluate long-term effects.