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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/cdn\/css\/http\/css_Xg7z6oCTVgud_Q0huYz9x9iiD5H_2YPSJ5z2ZViSWdY.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EIn patients with relapsing multiple sclerosis who participated in the TRANSFORMS trial, magnetic resonance imaging activity and relapses in the first year predicted clinical outcomes over 3 years of the extension trial. Switching from interferon beta-1a to fingolimod at 12 months reduced the proportion of patients with focal magnetic resonance imaging activity and relapse by 70%.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003Efingolimod\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Emultiple sclerosis\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Erelapse\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Efocal MRI\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ETRANSFORMS\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ENCT00340834\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eextension\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Einterferon beta-1a\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eneurology clinical trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Edemyelinating diseases\u003C\/li\u003E\u003C\/ul\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\n         \n         \u003Cp id=\u0022p-2\u0022\u003EThe TRANSFORMS trial [Cohen JA et al. \u003Cem\u003EN Engl J Med\u003C\/em\u003E. 2010] randomized 1292 patients with relapsing multiple sclerosis with a recent history of \u2265\u20051 relapse to oral fingolimod 1.25 or 0.5 mg or intramuscular interferon beta-1a (IFN-\u03b2-1a) 30 \u03bcg weekly. At 12 months, patients who received fingolimod had a significantly lower annualized relapse rate than the group who received IFN-\u03b2-1a (\u003Cem\u003EP\u003C\/em\u003E\u2005\u0026lt;\u2005.001 for both doses of fingolimod vs IFN-\u03b2-1a).\u003C\/p\u003E\n         \u003Cp id=\u0022p-3\u0022\u003EIn the TRANSFORMS extension trial [\u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT00340834\u0026amp;atom=%2Fspmdc%2F15%2F9%2F17.2.atom\u0022\u003ENCT00340834\u003C\/a\u003E], 1030 patients who were randomly assigned to receive either dose of fingolimod continued on that same dose. Patients who were originally randomized to IFN-\u03b2-1a were now randomly reassigned to fingolimod 0.5 or 1.25 mg. The efficacy end points were annualized relapse rate, disability progression, and magnetic resonance imaging (MRI) outcomes [Khatri B et al. \u003Cem\u003ELancet Neurol\u003C\/em\u003E. 2011]. Patients who took fingolimod throughout 24 months (TRANSFORMS plus extension) showed a sustained improvement in clinical and MRI outcomes. Patients who switched from IFN-\u03b2-1a to fingolimod at 12 months experienced improvements in relapse rate and MRI findings compared with the previous 12 months.\u003C\/p\u003E\n         \u003Cp id=\u0022p-4\u0022\u003EPavle Repovic, MD, PhD, Swedish Neuroscience Institute, Seattle, Washington, USA, presented 2 post hoc analyses in a poster using data from TRANSFORMS and the extension trial. The goal of these analyses was to determine whether year 1 MRI results and relapse rates could predict relapses or 6-month confirmed disability progression, measured by Expanded Disability Severity Scale over the following 36 months in the TRANSFORMS extension. An additional analysis explored outcomes at 24 months following the switch from IFN-\u03b2-1a to fingolimod at 12 months.\u003C\/p\u003E\n         \u003Cp id=\u0022p-5\u0022\u003EAccording to unadjusted logistic regression, significant predictors (\u003Cem\u003EP\u003C\/em\u003E\u2005\u0026lt;\u2005.01) for either relapses or 6-month confirmed disability progression were MRI activity in year 1, relapses in year 1, and combined MRI activity and relapses in year 1.\u003C\/p\u003E\n         \u003Cp id=\u0022p-6\u0022\u003EThe proportion of patients with MRI activity and relapses from baseline to month 12 was 12.9% for IFN-\u03b2-1a and 4.9% for fingolimod 0.5 mg. At months 12 to 24, the proportion remained low (3.2%) for continuous fingolimod. When patients were switched from IFN-\u03b2-1a to fingolimod, the proportion of patients with MRI activity and relapses decreased to 3.9%, which represented a 70% reduction (\u003Cem\u003EP\u2005\u003C\/em\u003E=\u2005.0014).\u003C\/p\u003E\n         \u003Cp id=\u0022p-7\u0022\u003EIn conclusion, MRI activity and relapses during year 1 were predictors of later clinical outcomes. Switching from IFN-\u03b2-1a to fingolimod after year 1 reduced the proportion of patients experiencing MRI activity and relapses, which may be associated with improved long-term outcomes.\u003C\/p\u003E\n      \u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2015 SAGE Publications\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/15\/9\/17.2.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzlo8q\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}