https://m2.mtmt.hu/ hun 2026-09-22 05:43 JournalArticle 34517298 VALIDATED true 0 false 2026-06-13T23:56:39.749+0000 2025-04-24T06:40:03.781+0000 2024-01-19T09:38:28.951+0000 true 10080205 Szalóky-Siki Ágnes /api/admin/10080205 Admin true 2025-04-24T06:39:57.186+0000 2025-04-24T06:39:57.186+0000 2025-04-24T06:40:04.002+0000 true 10097128 Sass Dávid /api/admin/10097128 Admin true true false true 24 24 /api/publicationtype/24 PublicationType 1 true 24 JournalArticle true 10000359 Study Group true 24 24 /api/publicationtype/24 PublicationType 1 true 24 JournalArticle /api/subtype/10000359 Sokszerzős vagy csoportos szerzőségű szakcikk SubType 104 true 10000359 true 1 /api/category/1 Category true 1 Spelman, T. Comparative effectiveness and cost-effectiveness of natalizumab and fingolimod in rapidly evolving severe relapsing-remitting multiple sclerosis in the United Kingdom true true /api/journal/10036031 REVIEWED true false 10036031 false 10036031 true 1369-6998 1941-837X Journal FOREIGN 27 1 109 125 109 17 2024 AimTo evaluate the real-world comparative effectiveness and the cost-effectiveness, from a UK National Health Service perspective, of natalizumab versus fingolimod in patients with rapidly evolving severe relapsing-remitting multiple sclerosis (RES-RRMS).MethodsReal-world data from the MSBase Registry were obtained for patients with RES-RRMS who were previously either naive to disease-modifying therapies or had been treated with interferon-based therapies, glatiramer acetate, dimethyl fumarate, or teriflunomide (collectively known as BRACETD). Matched cohorts were selected by 3-way multinomial propensity score matching, and the annualized relapse rate (ARR) and 6-month-confirmed disability worsening (CDW6M) and improvement (CDI6M) were compared between treatment groups. Comparative effectiveness results were used in a cost-effectiveness model comparing natalizumab and fingolimod, using an established Markov structure over a lifetime horizon with health states based on the Expanded Disability Status Scale. Additional model data sources included the UK MS Survey 2015, published literature, and publicly available sources.ResultsIn the comparative effectiveness analysis, we found a significantly lower ARR for patients starting natalizumab compared with fingolimod (rate ratio [RR] = 0.65; 95% confidence interval [CI], 0.57-0.73) or BRACETD (RR = 0.46; 95% CI, 0.42-0.53). Similarly, CDI6M was higher for patients starting natalizumab compared with fingolimod (hazard ratio [HR] = 1.25; 95% CI, 1.01-1.55) and BRACETD (HR = 1.46; 95% CI, 1.16-1.85). In patients starting fingolimod, we found a lower ARR (RR = 0.72; 95% CI, 0.65-0.80) compared with starting BRACETD, but no difference in CDI6M (HR = 1.17; 95% CI, 0.91-1.50). Differences in CDW6M were not found between the treatment groups. In the base-case cost-effectiveness analysis, natalizumab dominated fingolimod (0.302 higher quality-adjusted life-years [QALYs] and 17,141 pound lower predicted lifetime costs). Similar cost-effectiveness results were observed across sensitivity analyses.ConclusionsThis MSBase Registry analysis suggests that natalizumab improves clinical outcomes when compared with fingolimod, which translates to higher QALYs and lower costs in UK patients with RES-RRMS. There are several medications used to treat people with relapsing remitting multiple sclerosis, such as interferon-based therapies (Betaferon/Betaseron (US), Rebif, Avonex, Extavia), glatiramer acetate (Copaxone), teriflunomide (Aubagio), and dimethyl fumarate (Tecfidera), collectively named BRACETD. Other treatments for multiple sclerosis (MS) have a narrower use, such as natalizumab (Tysabri) or fingolimod (Gilenya), among others.This study objective was to assess how well natalizumab and fingolimod helped treating MS (clinical effectiveness) and subsequently estimate what the cost of these treatments is in comparison to the benefit they bring to people with rapidly evolving severe MS that use them in the United Kingdom (UK) (cost-effectiveness).We used an international disease registry (MSBase), which collects clinical data from people with MS in various centers around the world to compare the effectiveness of natalizumab, fingolimod and BRACETD treatments. We used a technique called propensity score matching to obtain results from comparable patient groups. People treated with natalizumab had better disease control, namely with fewer relapses and higher improvement on their disability level, than patients on fingolimod or BRACETD. Conversely, there were no differences between each group of people on a measure called disability worsening.Based on these clinical results, we built an economic model that simulates the lifetime costs and consequences of treating people with MS with natalizumab in comparison with fingolimod. We found that using natalizumab was less costly and was more effective compared to using fingolimod in UK patients. true 2024 true true true false false NONE 2026-06-14 false 7 0 7 5 1 7 6 7 6 7 7 5 5 5 2 0 7 5 7 5 0 6 6 Folyóiratcikk Journal Article 24 7 Könyvrészlet Chapter in Book 25 0 Könyv Book 23 0 Egyéb konferenciaközlemény Conference paper 31 0 Egyéb konferenciakötet Conference proceedings 32 0 Oltalmi formák Protection forms 26 0 Disszertáció Thesis 28 0 Egyéb Miscellaneous 29 0 Alkotás Achievement 22 0 Kutatási adat Research data 33 0 Folyóiratcikk Journal Article 24 0 0 0 Könyvrészlet Chapter in Book 25 0 0 0 Könyv Book 23 0 0 0 Egyéb konferenciaközlemény Conference paper 31 0 0 0 Egyéb konferenciakötet Conference proceedings 32 0 0 0 Oltalmi formák Protection forms 26 0 0 0 Disszertáció Thesis 28 0 0 0 Egyéb Miscellaneous 29 0 0 0 Alkotás Achievement 22 0 0 0 Kutatási adat Research data 33 0 0 0 2024 0 1 1 1 1 2025 0 6 4 6 4 Q1 false false false false 2024-01-18T09:44:12.489+0000 Jahn Ferenc Dél-pesti Kórház; Neurológiai Klinika (SE / AOK / K); Neurológiai Klinika (SZTE / SZAOK); Neurológiai Osztály; Neurológiai Tanszék (DE / ÁOK) 4 15 5 63 0 true Language 10002 /api/language/10002 Angol English true 2 true PersonAuthorship 113970724 /api/authorship/113970724 1 0.0 true false false Spelman T. true false false AuthorshipType 1 /api/authorshiptype/1 0 true 0 true false true PersonAuthorship 113970725 /api/authorship/113970725 2 0.0 false false false Herring W. 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title="Idézőközlemény" style="float: left" src="/frontend/resources/grid/publication-citation-icon.png"> <div class="autype autype0"> <span class="author-name" >Spelman T. </span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" mtid="10035469"><a href="/gui2/?type=authors&mode=browse&sel=10035469" target="_blank">Csepany T. (<span class="authorship-author-name">Csépány Tünde</span> <span class="authorAux-mtmt"> neurológia</span>) </a> </span> <span class="author-affil"><span title="Debreceni Egyetem">DE</span>/<span title="Általános Orvostudományi Kar">ÁOK</span>/Neurológiai Tanszék</span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" mtid="10031480"><a href="/gui2/?type=authors&mode=browse&sel=10031480" target="_blank">Rozsa C. (<span class="authorship-author-name">Rózsa Csilla</span> <span class="authorAux-mtmt"> neurológia</span>) </a> </span> <span class="author-affil">Jahn Ferenc Dél-pesti Kórház; <span title="Jahn Ferenc Dél-pesti Kórház">Jahn Ferenc Dél-pesti Kórház</span>/Neurológiai Osztály</span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" mtid="10023992"><a href="/gui2/?type=authors&mode=browse&sel=10023992" target="_blank">Simo M. (<span class="authorship-author-name">Simó Magdolna</span> <span class="authorAux-mtmt"> Neuroimmonológia, Izombetegségek, Elektrofiziol...</span>) </a> </span> <span class="author-affil"><span title="Semmelweis Egyetem">SE</span>/<span title="Általános Orvostudományi Kar">AOK</span>/<span title="Klinikum">K</span>/Neurológiai Klinika</span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" mtid="10000676"><a href="/gui2/?type=authors&mode=browse&sel=10000676" target="_blank">Rajda C. (<span class="authorship-author-name">Rajda Cecília</span> <span class="authorAux-mtmt"> Neuroimmunológia, sclerosis multiplex</span>) </a> </span> <span class="author-affil"><span title="Szegedi Tudományegyetem">SZTE</span>/<span title="Szent-Györgyi Albert Orvostudományi Kar">SZAOK</span>/Neurológiai Klinika</span> ;&nbsp;&nbsp;&nbsp; et al. (63) </div> <div><a target="_blank" href="/api/publication/34517298?labelLang=hun">Összes szerző</a></div> </div> <div class="title"><a href="/gui2/?mode=browse&params=publication;34517298" target="_blank">Comparative effectiveness and cost-effectiveness of natalizumab and fingolimod in rapidly evolving severe relapsing-remitting multiple sclerosis in the United Kingdom</a></div> <div> <span class="journal-title">JOURNAL OF MEDICAL ECONOMICS</span> <span class="journal-issn">(<a target="_blank" href="https://portal.issn.org/resource/ISSN/1369-6998">1369-6998</a> <a target="_blank" href="https://portal.issn.org/resource/ISSN/1941-837X">1941-837X</a>)</span>: <span class="journal-volume">27</span> <span class="journal-issue">1</span> <span class="page"> pp 109-125 </span> <span class="year">(2024)</span> </div> <div class="pub-footer"> <span class="language" xmlns="http://www.w3.org/1999/html">Nyelv: Angol | </span> <span class="identifiers"> <span class="id identifier oa_none" title="none"> <a style="color:blue" title="10.1080/13696998.2023.2293379" target="_blank" href="https://doi.org/10.1080/13696998.2023.2293379"> DOI </a> </span> <span class="id identifier oa_none" title="none"> <a style="color:blue" title="001130397900001" target="_blank" href="https://www.webofscience.com/wos/woscc/full-record/001130397900001"> WoS </a> </span> <span class="id identifier oa_none" title="none"> <a style="color:blue" title="85181176590" target="_blank" href="http://www.scopus.com/record/display.url?origin=inward&eid=2-s2.0-85181176590"> Scopus </a> </span> <span class="id identifier oa_none" title="none"> <a style="color:blue" title="38085684" target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=38085684&dopt=Abstract"> PubMed </a> </span> <span class="id identifier oa_NONE" title=" Nincs "> <a style="color:blue" title="https://www.tandfonline.com/doi/full/10.1080/13696998.2023.2293379" target="_blank" href="https://www.tandfonline.com/doi/full/10.1080/13696998.2023.2293379"> Egyéb URL </a> </span> </span> <OnlyViewableByAuthor><div class="ratings"> <div class="journal-subject">Folyóirat szakterülete: Scopus - Health Policy&nbsp;&nbsp;&nbsp;SJR indikátor:&nbsp;Q1</div> </div></OnlyViewableByAuthor> <div class="publication-citation" style="margin-left: 0.5cm;"> <span title="Nyilvános idézőközlemények összesen, említések nélkül" class="citingPub-count">Nyilvános idéző összesen: 7</span> | Független: 5 | Függő: 2 | Nem jelölt: 0 | WoS jelölt: 7 | Scopus jelölt:&nbsp;6 | WoS/Scopus jelölt:&nbsp;7 | DOI jelölt:&nbsp;6 </div> <div class="publication-citation"> <a target="_blank" href="/api/publication?cond=citations.related;eq;34517298&sort=publishedYear,desc&sort=title"> Idézett közlemények száma: 6 </a> </div> <div class="mtid"><span class="long-pub-mtid">Közlemény: 34517298</span> | <span class="status-data status-VALIDATED"> Egyeztetett </span> Forrás Idéző | <span class="type-subtype">Folyóiratcikk ( Sokszerzős vagy csoportos szerzőségű szakcikk ) </span> | <span class="pub-category">Tudományos</span> | <span class="publication-sourceOfData">WOS TAGGED</span> </div> <div class="lastModified">Utolsó módosítás: 2025.04.24. 08:40 Sass Dávid (SZTE admin5) </div> </div></div>