{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T13:36:44Z","timestamp":1789911404126,"version":"4.0.1"},"reference-count":38,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2016,7,11]],"date-time":"2016-07-11T00:00:00Z","timestamp":1468195200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Mult Scler"],"published-print":{"date-parts":[[2016,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Natalizumab and fingolimod have not been compared in controlled trials but only in observational studies, with inconclusive results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>The objective of this study is to compare the effect of natalizumab and fingolimod in reducing disease activity in relapsing-remitting multiple sclerosis (RRMS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We included all consecutive RRMS patients switched from first-line agents (glatiramer acetate\/interferons) to natalizumab or fingolimod, with a follow-up of 24\u2009months. Data of relapses, Expanded Disability Status Scale score and brain magnetic resonance imaging (MRI) scans were collected. We used propensity score (PS) matching and intention-to-treat analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>We retained 102 patients in each cohort after PS matching, with similar baseline characteristics. More patients discontinued natalizumab compared to fingolimod (33% vs 11%, p\u2009&lt;\u20090.001), mainly for progressive multifocal leukoencephalopathy (PML) concern. No serious adverse events occurred in the two cohorts. Compared to fingolimod, the natalizumab group presented a higher percentage of relapse-free patients (66% vs 80%, p\u2009=\u20090.015), a higher percentage of disability-improved patients (6% vs 15%, p\u2009=\u20090.033), a lower percentage of MRI-active patients (38% vs 14%, p\u2009=\u20090.001) and a higher percentage of patients with no evidence of disease activity (NEDA-3; 44% vs 70%, p\u2009&lt;\u20090.001) after 2\u2009years of follow-up. Disability worsening was not statistically different in the two groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Natalizumab is superior to fingolimod in RRMS patients non-responding to first-line agents.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1352458516650736","type":"journal-article","created":{"date-parts":[[2016,5,26]],"date-time":"2016-05-26T21:29:36Z","timestamp":1464298176000},"page":"1315-1326","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":65,"title":["Natalizumab versus fingolimod in patients with relapsing-remitting multiple sclerosis non-responding to first-line injectable therapies"],"prefix":"10.1177","volume":"22","author":[{"given":"Damiano","family":"Baroncini","sequence":"first","affiliation":[{"name":"Multiple Sclerosis Study Center, Sant\u2019Antonio Abate Hospital, Gallarate, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelo","family":"Ghezzi","sequence":"additional","affiliation":[{"name":"Multiple Sclerosis Study Center, Sant\u2019Antonio Abate Hospital, Gallarate, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro O","family":"Annovazzi","sequence":"additional","affiliation":[{"name":"Multiple Sclerosis Study Center, Sant\u2019Antonio Abate Hospital, Gallarate, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Colombo","sequence":"additional","affiliation":[{"name":"Department of Neurology, San Raffaele Hospital, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vittorio","family":"Martinelli","sequence":"additional","affiliation":[{"name":"Department of Neurology, San Raffaele Hospital, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgio","family":"Minonzio","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, Sant\u2019Antonio Abate Hospital, Gallarate, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucia","family":"Moiola","sequence":"additional","affiliation":[{"name":"Department of Neurology, San Raffaele Hospital, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariaemma","family":"Rodegher","sequence":"additional","affiliation":[{"name":"Department of Neurology, San Raffaele Hospital, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauro","family":"Zaffaroni","sequence":"additional","affiliation":[{"name":"Multiple Sclerosis Study Center, Sant\u2019Antonio Abate Hospital, Gallarate, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giancarlo","family":"Comi","sequence":"additional","affiliation":[{"name":"Department of Neurology, San Raffaele Hospital, Milan, Italy\/Division of Neuroscience, Department of Neurology, Institute of Experimental Neurology, San Raffaele Scientific Institute, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2016,7,11]]},"reference":[{"key":"bibr1-1352458516650736","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa044397"},{"key":"bibr2-1352458516650736","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(14)70049-3"},{"key":"bibr3-1352458516650736","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0909494"},{"key":"bibr4-1352458516650736","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0907839"},{"key":"bibr5-1352458516650736","first-page":"763418","volume":"2015","author":"Totaro R","year":"2015","journal-title":"Mult Scler Int"},{"key":"bibr6-1352458516650736","doi-asserted-by":"publisher","DOI":"10.3109\/00207454.2014.969839."},{"key":"bibr7-1352458516650736","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2015-310597."},{"key":"bibr8-1352458516650736","doi-asserted-by":"publisher","DOI":"10.1007\/s10072-010-0344-z"},{"key":"bibr9-1352458516650736","doi-asserted-by":"publisher","DOI":"10.1111\/ene.12204"},{"key":"bibr10-1352458516650736","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2013-306936"},{"key":"bibr11-1352458516650736","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0088472"},{"key":"bibr12-1352458516650736","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2014.4147"},{"key":"bibr13-1352458516650736","doi-asserted-by":"publisher","DOI":"10.1002\/acn3.180"},{"key":"bibr14-1352458516650736","unstructured":"European Medicines Agency. Tysabri (natalizumab): Summary of product characteristics, 2012, http:\/\/www.ema.europa.eu\/docs\/en_GB\/document_library\/EPAR_-_Product_Information\/human\/000603\/WC500044686.pdf (accessed 21 March 2015)."},{"key":"bibr15-1352458516650736","unstructured":"European Medicines Agency. Gilenya 0.5\u2009mg hard capsules: Summary of product characteristics, http:\/\/www.ema.europa.eu\/docs\/en_GB\/document_library\/EPAR_-_Product_Information\/human\/002202\/WC500104528.pdf (accessed 5 April 2015)."},{"key":"bibr16-1352458516650736","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000000541"},{"key":"bibr17-1352458516650736","doi-asserted-by":"publisher","DOI":"10.1097\/WCO.0b013e328360279f"},{"key":"bibr18-1352458516650736","doi-asserted-by":"publisher","DOI":"10.1177\/1352458511435105"},{"key":"bibr19-1352458516650736","doi-asserted-by":"publisher","DOI":"10.1002\/ana.24286"},{"key":"bibr20-1352458516650736","doi-asserted-by":"publisher","DOI":"10.1177\/1352458511410344"},{"key":"bibr21-1352458516650736","doi-asserted-by":"publisher","DOI":"10.1177\/1352458512438456"},{"key":"bibr22-1352458516650736","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2013.11.001"},{"key":"bibr23-1352458516650736","unstructured":"Brooks M. Third case of PML with fingolimod (\n                      Gilenya\n                      ) in MS. Medscape Medical News, 18 August 2015, http:\/\/www.medscape.com\/viewarticle\/849677 (accessed 20 September 2015)."},{"key":"bibr24-1352458516650736","doi-asserted-by":"publisher","DOI":"10.1185\/03007995.2014.915802"},{"key":"bibr25-1352458516650736","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-013-7082-0"},{"key":"bibr26-1352458516650736","doi-asserted-by":"publisher","DOI":"10.1177\/1352458514535282"},{"key":"bibr27-1352458516650736","doi-asserted-by":"publisher","DOI":"10.1159\/000361044"},{"key":"bibr28-1352458516650736","doi-asserted-by":"publisher","DOI":"10.1002\/ana.24339"},{"key":"bibr29-1352458516650736","unstructured":"The impact of natalizumab versus fingolimod on central nervous system (CNS) tissue damage and recovery in active relapsing-remitting multiple sclerosis (RRMS) subjects (REVEAL). 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