WED 181 Switching early from oral DMT to fingolimod in RRMS patients

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ObjectivesCompare the effect of fingolimod in RRMS patients who switched from first-line oral disease modifying therapies (oDMTs) vs patients who switched from injectable disease-modifying therapies (iDMTs) in PASSAGE and PANGAEA 2.0 studies.MethodsPatients who switched to fingolimod from dimethyl fumarate or teriflunomide (oDMT cohort; PASSAGE n=157, PANGAEA 2.0 n=72), or treatment naïve or after iDMTs (iDMT cohort; PASSAGE n=3484, PANGAEA 2.0 n=270). Annualised relapse rate (ARR) was recorded at months (M) 12 and 24.ResultsPASSAGE: Fingolimod reduced ARR at M12 to 0.30 and 0.26 (oDMT and iDMT cohort). Increasingly higher BL ARR were observed in the oDMT cohort patients who had received two or three DMTs (ARR=1.47 and 1.53).PANGAEA 2.0: Fingolimod reduced ARR at M12 in both cohorts but was higher in the oDMT than in the iDMT cohort (0.19 vs 0.10, p=0.01). The BL ARR in the oDMT cohort increased with the number of failed DMTs before the switch (two DMTs, 1.58; three DMTs, 1.86) and was reduced with fingolimod treatment at M12 (two DMTs, 0.18; three DMTs, 0.21).ConclusionsFingolimod is effective in controlling disease activity in RRMS patients switching from other oDMTs. Switching early results in better relapse control within 1 year of initiation.DisclaimerPreviously presented at ECTRIMS 2017.

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