Derfuss T, Sastre-Garriga J, Montalban X, Rodegher M, Wuerfel J, Gaetano L, Tomic D, Azmon A, Wolf C, Kappos L. The ACROSS study: Long-term efficacy of fingolimod in patients with relapsing-remitting multiple sclerosis.
Mult Scler J Exp Transl Clin 2020;
6:2055217320907951. [PMID:
32284874 PMCID:
PMC7132565 DOI:
10.1177/2055217320907951]
[Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 12/18/2019] [Accepted: 12/23/2019] [Indexed: 01/10/2023] Open
Abstract
Background
In chronic diseases such as multiple sclerosis requiring lifelong treatment,
studies on long-term outcomes are important.
Objective
To assess disability and magnetic resonance imaging-related outcomes in
relapsing multiple sclerosis patients from a Phase 2 study of fingolimod 10
or more years after randomization and to compare outcomes in patients who
had a higher fingolimod exposure versus those with a lower fingolimod
exposure.
Methods
ACROSS was a cross-sectional follow-up study of patients originally enrolled
in a Phase 2 fingolimod proof-of-concept study (NCT00333138). Disability and
magnetic resonance imaging-related outcomes were assessed in patients
grouped according to fingolimod treatment duration, based on an arbitrary
cut-off: ≥8 years (high exposure) and <8 years (low exposure).
Results
Overall, 175/281 (62%) patients participated in ACROSS; 104 (59%) of these
were classified “high exposure.” At 10 years, patients in the high-exposure
group had smaller increases in Expanded Disability Status Scale (+0.55 vs.
+1.21), and lower frequencies of disability progression (34.7% vs. 56.1%),
wheelchair use (4.8% vs. 16.9%), or transition to secondary progressive
multiple sclerosis (9.6% vs. 22.5%) than those in the low-exposure group.
The high-exposure patients also had less progression in most magnetic
resonance imaging-related outcomes.
Conclusion
After 10 years of fingolimod treatment, disability progression was lower in
the high-exposure group than in the low-exposure group.
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