This MS drug switch means fewer relapses in study

Published: 30 November 2022

People with multiple sclerosis (MS) who switched from Gilenya (fingolimod) experienced fewer relapses than those who changed to Tysabri (natalizumab) or Mavenclad (cladribine) in a new study.

The research included data from 1,045 patients from 26 countries. Each patient had been taking Gilenya for six months or more and then moved to another therapy within three months of stopping Gilenya.

Disability worsening rates were similar on Tysabri and Ocrevus, but those taking Tysabri were more likely to see disability improvements or less disability than patients on Ocrevus.

Overall, the relapse rates for those taking Ocrevus were lower than those on Tysabri, with the Ocrevus patients around 43% less likely to have a first relapse. Rates of relapse for those on Tysabri were lower than those on Mavenclad, but the risk of the first relapse wasn’t significantly different between them.

Disability worsening was similar between Ocrevus and Tysabri patients, though those on Tysabri were 51% more likely to see disability improvement after switching from Gilenya, and this improvement lasted until the end of the follow-up a year later.

“Our results comparing [Ocrevus] to [Tysabri] appear to be inconsistent,” said the researchers. “However, we do not consider these results to be contradictory.” They noted improved disability is usually due to repair happening in the nervous system, whereas relapses usually indicate new damage. “These mechanisms could easily be differentially affected by the different mechanisms of action” of the two therapies,” they said.