Background: Clinical and real-world studies have shown significant reductions in MS relapses in patients receiving fingolimod versus injectable disease-modifying therapies (iDMTs). The objective was to compare MS relapse rate and incidence in patients switching from an iDMT to fingolimod with those cycling from one iDMT to another or those remaining on their original iDMT.
Methods: A retrospective analysis was performed using MarketScan® Commercial and Medicare Supplemental claims data (July-1-2010–June-30-2016). Adult MS patients receiving ≥1 iDMT during the study were included. Relapses were identified from an MS-related hospitalization, outpatient ER or office visit, and corticosteroid administration. Annualized relapse rate ratio was estimated by negative binomial regression model with repeat-measures.
Results: Of 16,352 patients, 1,110 were switchers to fingolimod, 908 were iDMT cyclers, and 14,334 were non-switchers. At baseline, rate and incidence of MS relapses were higher in switchers and iDMT cyclers versus non-switchers (P < .001); mean (SD) relapse rates declined from 0.4 (0.7), 0.4 (0.7), and 0.2 (0.5) at baseline to 0.2 (0.5), 0.3 (0.6), and 0.1 (0.4) after follow-up in switchers, iDMT cyclers, and non-switchers, respectively. Relapse incidence also declined in each cohort. The highest reductions in relapse rate and incidence were observed in switchers to fingolimod, where relapse risk was significantly reduced versus iDMT cyclers (22%; P = .0433) and non-switchers (47%; P < .001).
Conclusions: This real-world study provides evidence that patients switching from an iDMT to fingolimod have the highest reductions in annualized rate and incidence of MS relapses, and significantly reduced risk of relapse, versus iDMT cyclers and non-switchers.