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IRIS
BACKGROUND: Ofatumumab, a subcutaneous anti-CD20 monoclonal antibody, selectively depletes B cells. Teriflunomide, an oral inhibitor of pyrimidine synthesis, reduces T-cell and B-cell activation. The relative effects of these two drugs in patients with multiple sclerosis are not known. METHODS: In two double-blind, double-dummy, phase 3 trials, we randomly assigned patients with relapsing multiple sclerosis to receive subcutaneous ofatumumab (20 mg every 4 weeks after 20-mg loading doses at days 1, 7, and 14) or oral teriflunomide (14 mg daily) for up to 30 months. The primary end point was the annualized relapse rate. Secondary end points included disability worsening confirmed at 3 months or 6 months, disability improvement confirmed at 6 months, the number of gadolinium-enhancing lesions per T1-weighted magnetic resonance imaging (MRI) scan, the annualized rate of new or enlarging lesions on T2-weighted MRI, serum neurofilament light chain levels at month 3, and change in brain volume. RESULTS: Overall, 946 patients were assigned to receive ofatumumab and 936 to receive teriflunomide; the median follow-up was 1.6 years. The annualized relapse rates in the ofatumumab and teriflunomide groups were 0.11 and 0.22, respectively, in trial 1 (difference, -0.11; 95% confidence interval [CI], -0.16 to -0.06; P<0.001) and 0.10 and 0.25 in trial 2 (difference, -0.15; 95% CI, -0.20 to -0.09; P<0.001). In the pooled trials, the percentage of patients with disability worsening confirmed at 3 months was 10.9% with ofatumumab and 15.0% with teriflunomide (hazard ratio, 0.66; P = 0.002); the percentage with disability worsening confirmed at 6 months was 8.1% and 12.0%, respectively (hazard ratio, 0.68; P = 0.01); and the percentage with disability improvement confirmed at 6 months was 11.0% and 8.1% (hazard ratio, 1.35; P = 0.09). The number of gadolinium-enhancing lesions per T1-weighted MRI scan, the annualized rate of lesions on T2-weighted MRI, and serum neurofilament light chain levels, but not the change in brain volume, were in the same direction as the primary end point. Injection-related reactions occurred in 20.2% in the ofatumumab group and in 15.0% in the teriflunomide group (placebo injections). Serious infections occurred in 2.5% and 1.8% of the patients in the respective groups. CONCLUSIONS: Among patients with multiple sclerosis, ofatumumab was associated with lower annualized relapse rates than teriflunomide. (Funded by Novartis; ASCLEPIOS I and II ClinicalTrials.gov numbers, NCT02792218 and NCT02792231.).
Ofatumumab versus Teriflunomide in Multiple Sclerosis / Hauser, S. L.; Bar-Or, A.; Cohen, J. A.; Comi, G.; Correale, J.; Coyle, P. K.; Cross, A. H.; de Seze, J.; Leppert, D.; Montalban, X.; Selmaj, K.; Wiendl, H.; Kerloeguen, C.; Willi, R.; Li, B.; Kakarieka, A.; Tomic, D.; Goodyear, A.; Pingili, R.; Haring, D. A.; Ramanathan, K.; Merschhemke, M.; Kappos, L.; Stephen, L Hauser; Kappos, Ludwig; Bar-Or, Amit; Jeffrey, A Cohen; Comi, Giancarlo; Correale, Jorge; Patricia, K Coyle; Cross, Anne; Jerome de Seze, ; Montalban, Xavier; Selmaj, Krzysztof; Wiendl, Heinz; Stephen, C Reingold; Garry, R Cutter; Doerner, Thomas; Hartung, Hans-Peter; Per Soelberg Sørensen, ; Steiner, Israel; Jerry, S Wolinsky; Ballario, Carlos; Christian Calvo Vildoso, ; Jorge Gustavo Jose, ; Norma Haydee Deri, ; Liwacki, Susana; Lechner-Scott, Jeannette; Parratt, John; Hodgkinson, Suzanne; Maida, Eva-Maria; Leutmezer, Fritz; Willekens, Barbara; Bart Van Wijmeersch, ; Laureys, Guy; Caekebeke, Jo; Geens, Karine; Vanopdenbosch, Ludo; Deryck, Olivier; Delvaux, Valerie; Vincent Van Pesch, ; Milanov, Ivan; Tarnev, Ivaylo; Haralanov, Lyubomir; Maria Manova Slavova, ; Shotekov, Penko; Emond, Francois; Grandmaison, Francois; Jacques, Francois; Lee, Liesly; Marie Sarah Gagne Brosseau, ; Freedman, Mark; Cloutier, Martin; Carruthers, Robert; Morrow, Sarah; Lapierre, Yves; Vladic, Anton; Bokun, Hana; Antoncic, Igor; Marija Bosnjak Pasic, ; Habek, Mario; Silva Butkovic Soldo, ; Vuletic, Vladimira; Martinkova, Alena; Meluzinova, Eva; Stetkarova, Ivana; Mares, Jan; Markova, Jolana; Vachova, Marta; Valis, Martin; Tyblova, Michaela; Dufek, Michal; Skoda, Ondrej; Hradilek, Pavel; Ana Voldsgaard Jensen, ; Helle Hvilsted Nielsen, ; Svendsen, Kristina; Ravnborg, Mads; Peter Vestergaard Rasmussen, ; Gross-Paju, Katrin; Haldre, Sulev; Juha Pekka Eralinna, ; Sumelahti, Marja-Liisa; Brochet, Bruno; Louapre, Celine; Lebrun-Frenay, Christine; David Axel Laplaud, ; Edan, Gilles; Castelnovo, Giovanni; Debouverie, Marc; Vermersch, Patrick; Clavelou, Pierre; Labauge, Pierre; Berthele, Achim; Haghikia, Aiden; Kornhuber, Anselm; Bergmann, Arnfin; Frank, Benedikt; Elias-Hamp, Birte; Tackenberg, Bjoern; Wildemann, Brigitte; Strauss, Erik; Schlegel, Eugen; Florian Then Bergh, ; Nelles, Gereon; Tumani, Hayrettin; Sigel, Karl-Otto; Stangel, Martin; Boehringer, Matthias; Olaf Martin Hoffmann, ; Oschmann, Patrick; Hohlfeld, Reinhard; Walter, Silke; Menck, Sylvia; Sprenger, Till; Ziemssen, Tjalf; Veit Ulrich Becker, ; Straeten, Vera; Kilidireas, Konstantinos; Voumvourakis, Konstantinos; Fakas, Nikolaos; Grigoriadis, Nikolaos; Koves, Agnes; Rozsa, Csilla; Kovacs, Krisztina; Vecsei, Laszlo; Maria, Satori; Biro, Zita; Rohatgi, Anshu; Khurana, Dheeraj; Jeyaraj Durai Pandian, ; Joy Dev Mukherji, ; Pandit, Lekha; Meena Angamuthu Kanikannan, ; Ghosh, Pahari; Chakor, Rahul; Kulkarni, Rahul; Gursahani, Roopkumar; Ravat, Sangeeta; Rangasetty, Srinivasa; Kumar, Suresh; Shifrin, Alla; Karni, Arnon; Shahien, Radi; Milo, Ron; Uccelli, Antonio; Pozzilli, Carlo; Sacca, Francesco; Lus, Giacomo; Girolama Alessandra Marfia, ; Brambilla, Laura; Salvetti, Marco; Filippi, Massimo; Zaffaroni, Mauro; Gallo, Paolo; Rossi, Silvia; Bonavita, Simona; Studer, Valeria; Millers, Andrejs; Karelis, Guntis; Kalnina, Jolanta; Mickeviciene, Dalia; Kizlaitiene, Rasa; Angelica Carbajal Ramirez, ; Juan Jose Lopez Prieto, ; Wokke, Beatrijs; Bob, W Van Oosten; Peter Van Domburg, ; Hupperts, Raymond; Rogier, Q Hintzen; Edland, Astrid; Castaneda, Cesar; Perez, Julio; Gavidia, Martin; Wiak, Andrzej; Karaszewski, Bartosz; Jasinska, Elzbieta; Halina Bartosik Psujek, ; Jastrzebska, Iwona; Slawek, Jaroslaw; Maciejowski, Maciej; Dziki, Miroslaw; Monika Adamczyk Sowa, ; Bonek, Robert; Fryze, Waldemar; Ana Martins Da Silva, ; Timoteo, Angela; Antonio Vasco Salgado, ; Capela, Carlos; Veira, Carlos; Correia, Filipe; Cerqueira, Joao; Joao De Sa, ; Livia De Sousa, ; Gouveia, Raquel; Alina Sergeevna Agafina, ; Anna Naumovna Belova, ; Denis Viktorovich Sazonov, ; Pokhabov, Dmitry; Ekaterina Igorevna Kairbekova, ; Elena Gennadievna Arefieva, ; Farit Axatovich Khabirov, ; Igor Vyacheslavovich Litvinenko, ; Stolyarov, Igor; Irina Aleksandrovna Sokolova, ; Larisa Ivanovna Volkova, ; Maria Vafaevna Davydovskaya, ; Maria Nikolaevna Zaharova, ; Nadezhda Alekseevna Malkova, ; Natalia Agafonovna Totolyan, ; Nikolay Vasilievich Dorogov, ; Stella Anatolievna Sivertseva, ; Kurca, Egon; Krastev, Georgi; Brozman, Miroslav; Koleda, Peter; Turcani, Peter; Valkovic, Peter; Hancinova, Viera; Donath, Vladimir; Retief, Chris; Isaacs, Michael; Albert Saiz Hinarejos, ; Alfredo Rodriguez Antigüedad, ; Bonaventura Casanova Estruch, ; Oreja-Guevara, Celia; Gemma Reig Rosello, ; Jose Carlos Alvarez Cermeño, ; Jose Martinez Rodriguez, ; Jose Meca Lallana, ; Juan Antonio Garcia Merino, ; Lucia Forero Diaz, ; Lucienne Costa Frossard Franca, ; Luis Querol Gutierrez, ; Lluis Ramio Torrenta, ; Pedro Serrano Castro, ; Rafael Arroyo Gonzalez, ; Sara Eichau Madueño, ; Sergio Martinez Yelamos, ; Tamara Castillo Trivino, ; Virgina Meca Lallana, ; Xaviere Montalban Gairin, ; Piehl, Fredrik; Lycke, Jan; Zecca, Chiara; Derfuss, Tobias; Lin, Thy-Sheng; Tiamkao, Somsak; Ayse Nur Yuceyar, ; Soysal, Aysun; Belgin Petek Balci, ; Boz, Cavit; Efendi, Husnu; Terzi, Murat; Sevim, Serhan; Ozakbas, Serkan; Gale, Andrew; Turner, Ben; Barnes, David; Paling, David; Silber, Eli; Overell, James; Craner, Matthew; Carlson, Aaron; Wolff, Adam; Onuoha, Adaeze; Subei, Adnan; Ata, Ahmad; Borazanci, Aimee; Dastagir, Akram; Vasquez, Alberto; Alison Brooke Allen, ; Andrew, P Keegan; Carrasco, Angel; Angel, R Chinea Martinez; Bass, Ann; Okai, Annette; Erwin, April; Antezana-Antezana, Ariel; Green, Barbara; Bharathy, E Sundaram; Khatri, Bhupendra; Dihenia, Bhupesh; Gheorghiu, Bogdan; Costell, Brian; Steingo, Brian; Bruce, L Hughes; Carrie, M Hersh; Laganke, Christopher; Luzzio, Christopher; Ford, Corey; Craig Edward Herrman, ; Senzon, Craig; Huffman, Cynthia; Daniel, R Wynn; David D, O Bear; Lesch, David; David, H Mattson; Weisman, David; Deborah, A Burke; Dennis, W Dietrich; Huang, Deren; Robertson, Derrick; Lotfi, Djamchid; Don Joseph Alfonso, ; Stefoski, Dusan; Edward, J Fox; Pharr, Emily; Alvarez, Enrique; Bernitsas, Evanthia; Amjad, Faria; Pardo, Gabriel; Eubank, Geoffrey; Mcintosh, Gerald; Giles, F Crowell; Rao, Hemanth; J Michael Hemphill, ; Jack, H Florin; Nicholas, Jacqueline; Napier, James; Scott, James; Jason, M Silversteen; Vasallo, Javier; Schneider, Jean-Raphael; Wendt, Jeanette; Cohen, Jeffrey; Gross, Jeffrey; Groves, Jeffrey; Kaplan, Jeffrey; Stulc, Jessica; Joanna, A Cooper; Foley, John; Scagnelli, John; Jonathan, C Calkwood; Jose Pizarro Otero, ; Rafecas, Jose; Katz, Joshua; Juliette, S Saad; Standley, Katherine; Edwards, Keith; Sharlin, Kenneth; Bashir, Khurram; Wagner, Kimberly; Liow, Kore; Larry Lee Blankenship Jr, ; Mate, Laszlo; Montoya, Liliana; Lon, D Lynn; Agius, Mark; Cascione, Mark; Mark Allan Goldstein, ; Janicki, Mark; Martin, R Bialow; Mary Denise Hughes, ; Matthew, J Baker; Apperson, Michelle; Michelle, B Kuczma; M Mateo Paz Soldan, ; Cerghet, Mirela; Nathaniel Robb Whaley, ; Paul, K Winner; Repovic, Pavle; Kelkar, Praful; Romero Rekha Pillai, ; Ayala, Ricardo; Sater, Richard; Trudell, Randall; Robert Fairborn Armstrong, ; Robert Thomas Nahouraii, ; Naismith, Robert; Ronald, S Murray; Hunter, Samuel; Qureshi, Sara; Lynch, Sharon; Wray, Sibyl; Silvia, R Delgado; Donlon, Stacy; Cohan, Stanley; Smith, Stanya; Stuart James Shafer, ; Azalone, Susan; Hibbs, Susan; Tamara, A Miller; Giancarlo, Thomas; Desai, Troy; Varun, K Saxena; Simnad, Virginia; William David Honeycutt, ; Logan, William; William, E McElveen; Wagner, William. - In: THE NEW ENGLAND JOURNAL OF MEDICINE. - ISSN 0028-4793. - 383:6(2020), pp. 546-557. [10.1056/NEJMoa1917246]
Ofatumumab versus Teriflunomide in Multiple Sclerosis
Hauser S. L.;Bar-Or A.;Cohen J. A.;Comi G.;Correale J.;Coyle P. K.;Cross A. H.;de Seze J.;Leppert D.;Montalban X.;Selmaj K.;Wiendl H.;Kerloeguen C.;Willi R.;Li B.;Kakarieka A.;Tomic D.;Goodyear A.;Pingili R.;Haring D. A.;Ramanathan K.;Merschhemke M.;Kappos L.;Stephen L Hauser;Ludwig Kappos;Amit Bar-Or;Jeffrey A Cohen;Giancarlo Comi;Jorge Correale;Patricia K Coyle;Anne Cross;Jerome de Seze;Xavier Montalban;Krzysztof Selmaj;Heinz Wiendl;Stephen C Reingold;Garry R Cutter;Thomas Doerner;Hans-Peter Hartung;Per Soelberg Sørensen;Israel Steiner;Jerry S Wolinsky;Carlos Ballario;Christian Calvo Vildoso;Jorge Gustavo Jose;Norma Haydee Deri;Susana Liwacki;Jeannette Lechner-Scott;John Parratt;Suzanne Hodgkinson;Eva-Maria Maida;Fritz Leutmezer;Barbara Willekens;Bart Van Wijmeersch;Guy Laureys;Jo Caekebeke;Karine Geens;Ludo Vanopdenbosch;Olivier Deryck;Valerie Delvaux;Vincent Van Pesch;Ivan Milanov;Ivaylo Tarnev;Lyubomir Haralanov;Maria Manova Slavova;Penko Shotekov;Francois Emond;Francois Grandmaison;Francois Jacques;Liesly Lee;Marie Sarah Gagne Brosseau;Mark Freedman;Martin Cloutier;Robert Carruthers;Sarah Morrow;Yves Lapierre;Anton Vladic;Hana Bokun;Igor Antoncic;Marija Bosnjak Pasic;Mario Habek;Silva Butkovic Soldo;Vladimira Vuletic;Alena Martinkova;Eva Meluzinova;Ivana Stetkarova;Jan Mares;Jolana Markova;Marta Vachova;Martin Valis;Michaela Tyblova;Michal Dufek;Ondrej Skoda;Pavel Hradilek;Ana Voldsgaard Jensen;Helle Hvilsted Nielsen;Kristina Svendsen;Mads Ravnborg;Peter Vestergaard Rasmussen;Katrin Gross-Paju;Sulev Haldre;Juha Pekka Eralinna;Marja-Liisa Sumelahti;Bruno Brochet;Celine Louapre;Christine Lebrun-Frenay;David Axel Laplaud;Gilles Edan;Giovanni Castelnovo;Marc Debouverie;Patrick Vermersch;Pierre Clavelou;Pierre Labauge;Achim Berthele;Aiden Haghikia;Anselm Kornhuber;Arnfin Bergmann;Benedikt Frank;Birte Elias-Hamp;Bjoern Tackenberg;Brigitte Wildemann;Erik Strauss;Eugen Schlegel;Florian Then Bergh;Gereon Nelles;Hayrettin Tumani;Karl-Otto Sigel;Martin Stangel;Matthias Boehringer;Olaf Martin Hoffmann;Patrick Oschmann;Reinhard Hohlfeld;Silke Walter;Sylvia Menck;Till Sprenger;Tjalf Ziemssen;Veit Ulrich Becker;Vera Straeten;Konstantinos Kilidireas;Konstantinos Voumvourakis;Nikolaos Fakas;Nikolaos Grigoriadis;Agnes Koves;Csilla Rozsa;Krisztina Kovacs;Laszlo Vecsei;Satori Maria;Zita Biro;Anshu Rohatgi;Dheeraj Khurana;Jeyaraj Durai Pandian;Joy Dev Mukherji;Lekha Pandit;Meena Angamuthu Kanikannan;Pahari Ghosh;Rahul Chakor;Rahul Kulkarni;Roopkumar Gursahani;Sangeeta Ravat;Srinivasa Rangasetty;Suresh Kumar;Alla Shifrin;Arnon Karni;Radi Shahien;Ron Milo;Antonio Uccelli;Carlo Pozzilli;Francesco Sacca;Giacomo Lus;Girolama Alessandra Marfia;Laura Brambilla;Marco Salvetti;Massimo Filippi;Mauro Zaffaroni;Paolo Gallo;Silvia Rossi;Simona Bonavita;Valeria Studer;Andrejs Millers;Guntis Karelis;Jolanta Kalnina;Dalia Mickeviciene;Rasa Kizlaitiene;Angelica Carbajal Ramirez;Juan Jose Lopez Prieto;Beatrijs Wokke;Bob W Van Oosten;Peter Van Domburg;Raymond Hupperts;Rogier Q Hintzen;Astrid Edland;Cesar Castaneda;Julio Perez;Martin Gavidia;Andrzej Wiak;Bartosz Karaszewski;Elzbieta Jasinska;Halina Bartosik Psujek;Iwona Jastrzebska;Jaroslaw Slawek;Maciej Maciejowski;Miroslaw Dziki;Monika Adamczyk Sowa;Robert Bonek;Waldemar Fryze;Ana Martins Da Silva;Angela Timoteo;Antonio Vasco Salgado;Carlos Capela;Carlos Veira;Filipe Correia;Joao Cerqueira;Joao De Sa;Livia De Sousa;Raquel Gouveia;Alina Sergeevna Agafina;Anna Naumovna Belova;Denis Viktorovich Sazonov;Dmitry Pokhabov;Ekaterina Igorevna Kairbekova;Elena Gennadievna Arefieva;Farit Axatovich Khabirov;Igor Vyacheslavovich Litvinenko;Igor Stolyarov;Irina Aleksandrovna Sokolova;Larisa Ivanovna Volkova;Maria Vafaevna Davydovskaya;Maria Nikolaevna Zaharova;Nadezhda Alekseevna Malkova;Natalia Agafonovna Totolyan;Nikolay Vasilievich Dorogov;Stella Anatolievna Sivertseva;Egon Kurca;Georgi Krastev;Miroslav Brozman;Peter Koleda;Peter Turcani;Peter Valkovic;Viera Hancinova;Vladimir Donath;Chris Retief;Michael Isaacs;Albert Saiz Hinarejos;Alfredo Rodriguez Antigüedad;Bonaventura Casanova Estruch;Celia Oreja-Guevara;Gemma Reig Rosello;Jose Carlos Alvarez Cermeño;Jose Martinez Rodriguez;Jose Meca Lallana;Juan Antonio Garcia Merino;Lucia Forero Diaz;Lucienne Costa Frossard Franca;Luis Querol Gutierrez;Lluis Ramio Torrenta;Pedro Serrano Castro;Rafael Arroyo Gonzalez;Sara Eichau Madueño;Sergio Martinez Yelamos;Tamara Castillo Trivino;Virgina Meca Lallana;Xaviere Montalban Gairin;Fredrik Piehl;Jan Lycke;Chiara Zecca;Tobias Derfuss;Thy-Sheng Lin;Somsak Tiamkao;Ayse Nur Yuceyar;Aysun Soysal;Belgin Petek Balci;Cavit Boz;Husnu Efendi;Murat Terzi;Serhan Sevim;Serkan Ozakbas;Andrew Gale;Ben Turner;David Barnes;David Paling;Eli Silber;James Overell;Matthew Craner;Aaron Carlson;Adam Wolff;Adaeze Onuoha;Adnan Subei;Ahmad Ata;Aimee Borazanci;Akram Dastagir;Alberto Vasquez;Alison Brooke Allen;Andrew P Keegan;Angel Carrasco;Angel R Chinea Martinez;Ann Bass;Annette Okai;April Erwin;Ariel Antezana-Antezana;Barbara Green;Bharathy E Sundaram;Bhupendra Khatri;Bhupesh Dihenia;Bogdan Gheorghiu;Brian Costell;Brian Steingo;Bruce L Hughes;Carrie M Hersh;Christopher Laganke;Christopher Luzzio;Corey Ford;Craig Edward Herrman;Craig Senzon;Cynthia Huffman;Daniel R Wynn;David D O Bear;David Lesch;David H Mattson;David Weisman;Deborah A Burke;Dennis W Dietrich;Deren Huang;Derrick Robertson;Djamchid Lotfi;Don Joseph Alfonso;Dusan Stefoski;Edward J Fox;Emily Pharr;Enrique Alvarez;Evanthia Bernitsas;Faria Amjad;Gabriel Pardo;Geoffrey Eubank;Gerald Mcintosh;Giles F Crowell;Hemanth Rao;J Michael Hemphill;Jack H Florin;Jacqueline Nicholas;James Napier;James Scott;Jason M Silversteen;Javier Vasallo;Jean-Raphael Schneider;Jeanette Wendt;Jeffrey Cohen;Jeffrey Gross;Jeffrey Groves;Jeffrey Kaplan;Jessica Stulc;Joanna A Cooper;John Foley;John Scagnelli;Jonathan C Calkwood;Jose Pizarro Otero;Jose Rafecas;Joshua Katz;Juliette S Saad;Katherine Standley;Keith Edwards;Kenneth Sharlin;Khurram Bashir;Kimberly Wagner;Kore Liow;Larry Lee Blankenship Jr;Laszlo Mate;Liliana Montoya;Lon D Lynn;Mark Agius;Mark Cascione;Mark Allan Goldstein;Mark Janicki;Martin R Bialow;Mary Denise Hughes;Matthew J Baker;Michelle Apperson;Michelle B Kuczma;M Mateo Paz Soldan;Mirela Cerghet;Nathaniel Robb Whaley;Paul K Winner;Pavle Repovic;Praful Kelkar;Romero Rekha Pillai;Ricardo Ayala;Richard Sater;Randall Trudell;Robert Fairborn Armstrong;Robert Thomas Nahouraii;Robert Naismith;Ronald S Murray;Samuel Hunter;Sara Qureshi;Sharon Lynch;Sibyl Wray;Silvia R Delgado;Stacy Donlon;Stanley Cohan;Stanya Smith;Stuart James Shafer;Susan Azalone;Susan Hibbs;Tamara A Miller;Thomas Giancarlo;Troy Desai;Varun K Saxena;Virginia Simnad;William David Honeycutt;William Logan;William E McElveen;William Wagner
2020
Abstract
BACKGROUND: Ofatumumab, a subcutaneous anti-CD20 monoclonal antibody, selectively depletes B cells. Teriflunomide, an oral inhibitor of pyrimidine synthesis, reduces T-cell and B-cell activation. The relative effects of these two drugs in patients with multiple sclerosis are not known. METHODS: In two double-blind, double-dummy, phase 3 trials, we randomly assigned patients with relapsing multiple sclerosis to receive subcutaneous ofatumumab (20 mg every 4 weeks after 20-mg loading doses at days 1, 7, and 14) or oral teriflunomide (14 mg daily) for up to 30 months. The primary end point was the annualized relapse rate. Secondary end points included disability worsening confirmed at 3 months or 6 months, disability improvement confirmed at 6 months, the number of gadolinium-enhancing lesions per T1-weighted magnetic resonance imaging (MRI) scan, the annualized rate of new or enlarging lesions on T2-weighted MRI, serum neurofilament light chain levels at month 3, and change in brain volume. RESULTS: Overall, 946 patients were assigned to receive ofatumumab and 936 to receive teriflunomide; the median follow-up was 1.6 years. The annualized relapse rates in the ofatumumab and teriflunomide groups were 0.11 and 0.22, respectively, in trial 1 (difference, -0.11; 95% confidence interval [CI], -0.16 to -0.06; P<0.001) and 0.10 and 0.25 in trial 2 (difference, -0.15; 95% CI, -0.20 to -0.09; P<0.001). In the pooled trials, the percentage of patients with disability worsening confirmed at 3 months was 10.9% with ofatumumab and 15.0% with teriflunomide (hazard ratio, 0.66; P = 0.002); the percentage with disability worsening confirmed at 6 months was 8.1% and 12.0%, respectively (hazard ratio, 0.68; P = 0.01); and the percentage with disability improvement confirmed at 6 months was 11.0% and 8.1% (hazard ratio, 1.35; P = 0.09). The number of gadolinium-enhancing lesions per T1-weighted MRI scan, the annualized rate of lesions on T2-weighted MRI, and serum neurofilament light chain levels, but not the change in brain volume, were in the same direction as the primary end point. Injection-related reactions occurred in 20.2% in the ofatumumab group and in 15.0% in the teriflunomide group (placebo injections). Serious infections occurred in 2.5% and 1.8% of the patients in the respective groups. CONCLUSIONS: Among patients with multiple sclerosis, ofatumumab was associated with lower annualized relapse rates than teriflunomide. (Funded by Novartis; ASCLEPIOS I and II ClinicalTrials.gov numbers, NCT02792218 and NCT02792231.).
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11588/821664
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simulazione ASN
Il report seguente simula gli indicatori relativi alla propria produzione scientifica in relazione alle soglie ASN 2023-2025 del proprio SC/SSD. Si ricorda che il superamento dei valori soglia (almeno 2 su 3) è requisito necessario ma non sufficiente al conseguimento dell'abilitazione. La simulazione si basa sui dati IRIS e sugli indicatori bibliometrici alla data indicata e non tiene conto di eventuali periodi di congedo obbligatorio, che in sede di domanda ASN danno diritto a incrementi percentuali dei valori. La simulazione può differire dall'esito di un’eventuale domanda ASN sia per errori di catalogazione e/o dati mancanti in IRIS, sia per la variabilità dei dati bibliometrici nel tempo. Si consideri che Anvur calcola i valori degli indicatori all'ultima data utile per la presentazione delle domande.
La presente simulazione è stata realizzata sulla base delle specifiche raccolte sul tavolo ER del Focus Group IRIS coordinato dall’Università di Modena e Reggio Emilia e delle regole riportate nel DM 589/2018 e allegata Tabella A. Cineca, l’Università di Modena e Reggio Emilia e il Focus Group IRIS non si assumono alcuna responsabilità in merito all’uso che il diretto interessato o terzi faranno della simulazione. Si specifica inoltre che la simulazione contiene calcoli effettuati con dati e algoritmi di pubblico dominio e deve quindi essere considerata come un mero ausilio al calcolo svolgibile manualmente o con strumenti equivalenti.