Comparative effectiveness of glatiramer acetate and interferon beta formulations in relapsing – remitting multiple sclerosis

Tomas Kalincik, Vilija Jokubaitis, Guillermo Izquierdo, Pierre Duquette, Marc Girard, Pierre Grammond, Alessandra Lugaresi, Celia Oreja-Guevara, Robert Bergamaschi, Raymond Hupperts, Francois Grand'Maison, Eugenio Pucci, Vincent Van Pesch, Cavit Boz, Gerardo Iuliano, Ricardo Fernandez-Bolanos, Shlomo Fletcher, Daniele La Spitaleri, Edgardo Cristiano, Freek VerheulJeannette Lechner-Scott, M Amato, Jose Cabrera-Gomez, Maria Saladino, Mark Slee, Fraser Moore, Orla Gray, Mark Paine, Michael Barnett, Eva Havrdova, Dana Horakova, Timothy Spelman, Maria Trojano, Helmut Butzkueven

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    31 Citations (Scopus)


    Background: The results of head-to-head comparisons of injectable immunomodulators (interferon β, glatiramer acetate) have been inconclusive and a comprehensive analysis of their effectiveness is needed. Objective: We aimed to compare, in a real-world setting, relapse and disability outcomes among patientswith multiple sclerosis (MS) treated with injectable immunomodulators. Methods: Pairwise analysis of the international MSBase registry data was conducted using propensityscore matching. The four injectable immunomodulators were compared in six head-to-head analyses of relapse and disability outcomes using paired mixed models or frailty proportional hazards models adjusted for magnetic resonance imaging variables. Sensitivity and power analyses were conducted. Results: Of the 3326 included patients, 3451199 patients per therapy were matched (median pairwisecensored follow-up was 3.7 years). Propensity matching eliminated >95% of the identified indication bias. Slightly lower relapse incidence was found among patients treated with glatiramer acetate or subcutaneous interferon β-1a relative to intramuscular interferon β-1a and interferon β-1b (-rfpag≤0.001). No differences in 12-month confirmed progression of disability were observed. Conclusion: Small but statistically significant differences in relapse outcomes exist among the injectable immunomodulators. MSBase is sufficiently powered to identify these differences and reflects practice in tertiary MS centres. While the present study controlled indication, selection and attrition bias, centredependent variance in data quality was likely.

    Original languageEnglish
    Pages (from-to)1159-1171
    Number of pages13
    JournalMultiple Sclerosis
    Issue number9
    Early online date2015
    Publication statusPublished - 25 Aug 2015


    • disability
    • Multiple sclerosis
    • patient registry
    • propensity score
    • real-world date
    • Relapses
    • treatment outcomes


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