Gilenya (fingolimod) and Tecfidera (dimethyl fumarate) are similarly effective at lowering the frequency of relapses and delaying disability progression in people with relapsing-remitting multiple sclerosis (RRMS), a real-world study from Switzerland reported.
These efficacy measures were also consistent whether patients were new to a disease-modifying therapy (DMT) like Gilenya and Tecfidera, or switching to either treatment from another DMT, its researchers wrote.
The study, “Comparative analysis of dimethyl fumarate and fingolimod in relapsing–remitting multiple sclerosis,” was published in the Journal of Neurology.
Gilenya and Tecfidera, both oral medications, are used as first-line treatments for RRMS in Switzerland (in the U.S., they’re first-line therapies for all relapsing MS forms). Gilenya is marketed by Novartis and Tecfidera by Biogen; generic versions of both medicines have also been approved.
Although their exact mechanisms of action differ, each is thought to act by reducing the inflammatory activity of the immune system. Individually, Gilenya and Tecfidera have also shown effectiveness in clinical trials; however, the comparative efficacy of these two MS treatments is rarely examined.
In this study, funded by the University of Basel, researchers analyzed data derived from a Swiss national insurance database. They identified 961 patients starting treatment with Gilenya between 2014 and 2019, and another 961 starting with Tecfidera over these five years.
Mathematical modeling was used to ensure that both treatment groups were similar in terms of demographics and clinical features prior to starting treatment. Both groups were about 70% female, with an average age of about 40, and an average disease duration of about eight years. Roughly 40% of had never been treated before; the remainder had previously received other MS treatments, primarily interferon-beta therapies.
Median follow-up time was just under one year. Over this period, no statistically significant differences in relapse rates or in disability status — either in terms of worsening or progression — were seen between the two treatment groups.
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