BEST-MS: A prospective head-to-head comparative study of natalizumab and fingolimod in active relapsing MS

Background: There are few head-to-head studies to compare highly active treatments in multiple sclerosis (MS) Objective: The aim of this study was to compare the effectiveness between natalizumab (NTZ) and fingolimod (FTY) in active relapsing–remitting MS Method: Best Escalation STrategy in Multiple...

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Published in:	Multiple sclerosis Vol. 27; no. 10; pp. 1556 - 1563
Main Authors:	Cohen, Mikael, Mondot, Lydiane, Bucciarelli, Florence, Pignolet, Béatrice, Laplaud, David-Axel, Wiertlewski, Sandrine, Brochet, Bruno, Ruet, Aurélie, Defer, Gilles, Derache, Nathalie, Vermersch, Patrick, Zephir, Hélène, Debouverie, Marc, Mathey, Guillaume, Berger, Eric, Cappé, Chrystelle, Labauge, Pierre, Carra, Clarisse, De Seze, Jérôme, Bigaut, Kevin, Brassat, David, Lebrun-Frenay, Christine
Format:	Journal Article
Language:	English
Published:	London, England SAGE Publications 01-09-2021 Sage Publications Ltd
Subjects:	Fingolimod Hydrochloride / therapeutic use Human health and pathology Humans Immunology Infectious diseases Life Sciences Magnetic resonance imaging Monoclonal antibodies Multiple Sclerosis Multivariate analysis Natalizumab / therapeutic use Neoplasm Recurrence, Local Patients Prospective Studies Multiple sclerosis therapeutics magnetic resonance imaging fingolimod natalizumab
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Summary:	Background: There are few head-to-head studies to compare highly active treatments in multiple sclerosis (MS) Objective: The aim of this study was to compare the effectiveness between natalizumab (NTZ) and fingolimod (FTY) in active relapsing–remitting MS Method: Best Escalation STrategy in Multiple Sclerosis (BEST-MS) is a multicentric, prospective study with a 12-month follow-up including patients with active MS. Treatment choice was at the discretion of physician. Clinical and magnetic resonance imaging (MRI) data were collected at baseline and at 12 months. The primary outcome was the proportion of patients reaching no evidence of disease activity (NEDA) at 12 months. Secondary outcomes included annualized relapse rate and MRI activity. Results: A total of 223 patients were included (NTZ: 109 and FTY: 114). Treatment groups were well balanced at baseline. Proportion of NEDA patients was 47.8% in NTZ group versus 30.4% in FTY group (p = 0.015). This superiority was driven by annualized relapse rate and MRI activity. In the multivariate analysis, treatment group was the only factor associated with NEDA at 12 months with a lower probability in FTY group (odds ratio (OR) = 0.49, p = 0.029). Conclusion: BEST-MS is a prospective study that compared head-to-head the effectiveness of NTZ and FTY in active relapsing–remitting MS. Our results suggest a superiority of NTZ over FTY.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1352-4585 1477-0970
DOI:	10.1177/1352458520969145