Comparative effectiveness of autologous haematopoietic stem cell transplantation vs. fingolimod, ocrelizumab and natalizumab in relapsing-remitting MS

Abstract

Oral Presentations 28 (3S) 11 journals.sagepub.com/home/msj Multiple Sclerosis Journal 2022; 28: (3S) 3-129 probability of relapse in glatiramer acetate (OR=27.27; 95%CI= 9.15,81.29; p<0.01), dimethyl-fumarate (OR=10.60; 95%CI= 3.49,32.17; p<0.01), fingolimod (OR=16.28; 95%CI=5.35,49.52; p<0.01), and natalizumab (OR=17.20; 95%CI=5.66,52.29; p<0.01), compared with ocrelizumab. EDSS more likely increased in glatiramer acetate (OR=1.34; 95%CI=1.19,1.51; p<0.01), dimethyl-fumarate (OR=1.26; 95%CI=1.12,1.43; p<0.01), fingolimod (OR=1.59; 95%CI=1.41,1.80; p<0.01), and natalizumab (OR=1.86; 95%CI=1.63,2.12; p<0.01), compared with ocrelizumab. The probability of new/Gd-enhancing lesions was higher in glatiramer acetate (OR=4.02; 95%CI =1.74,9.27; p<0.01), compared with ocrelizumab, while no differences were found for dimethyl-fumarate (p=0.42), fingoli-mod (p=0.87), and natalizumab (p=0.11). On propensity score-adjusted Cox regression models, NEDA-3 status was achieved by 90.23% of patients treated with ocrelizumab, and, less so, glati-ramer acetate (44.24%; HR=12.52; 95%CI=9.55,16.42; p<0.01), dimethyl-fumarate (62.08%; HR=1.66; 95%CI=1.30,2.11; p<0.01), fingolimod (54.16%; HR=2.98; 95%CI=2.35,3.77; p<0.01), and natalizumab (57.72%; HR=1.71; 95%CI=1.32,2.21; p<0.01). Discussion: Ocrelizumab proved superior to other DMTs in achieving NEDA-3 status and reducing EDSS worsening, using propensity score adjustment. The less striking results on MRI lesions could be due to the limited sample size analysed. Further analyses on more MRI outcomes and in a larger group of patients is ongoing.