Relapsing Remitting Multiple Sclerosis
Conditions
Brief summary
A 12 month study where 852 patients with relapsing remitting MS will be randomized 1:1 to fingolimod or approved disease modifying therapy. Patients will be be treatment naive or have only been treated with one class of DMT (Interferon beta preparation or glatiramer acetate) . Patients will be able to switch to different treatment for safety, efficacy, tolerability or convenience during the study. Primary objective is to evaluate efficacy of fingolimod by assessing patients retention on treatment. Secondary objectives are to compare reasons for discontinuation, adverse events, cognitive impairment, medication satisfaction and change in brain volume measured by MRI.
Detailed description
852 Patients with relapsing remitting MS will be randomized 1:1 to fingolimod or approved first line DMTs. Patients must be either treatment naive or have received treatment with only one class of treatment (interferon beta preparation or glatiramer acetate) . Patients previously treated with DMT and randomized to the DMT arm may not remain on the same treatment for the study and will have to switch to a different class (i.e., previously treated with glatiramer acetate will switch to interferon beta preparaption, previously treated with interferon beta preparation will swtich to glatiramer acetate). Entry criteria at screening include but are not limited to, age 18-65, diagnosis with RRMS, EDSS \< or equal to 6, not pregnant or planning pregnancy and women of childbearing potential willing to use contraception throughout the study. Exclusion criteria include but are not limited to - prior exposure to fingolimod, history of malignancy within 5 years, other than RRMS types of MS, other diseases of the immune system, active macular edema, systemic bacterial, viral or fungal infections, patients without vaccine against varicella zoster, receipt of live or attentuated vaccines within a month of screening, history of various cardiac conditions, presence of certain ECG abnormalities, resting heart rate \< 45 bpm, symptomatic bradycardia, recurrent syncope, severe untreated sleep apnea, severe pulmonary conditions, various hepatic conditions, certain neurologic disorders, pregnancy. Patients may switch treatment before 3 months for safety reasons only, after 3 months for safety, efficacy, tolerability or convenience. Treatment switch during the study may be to any of study approved treatments irrespective of prior treatment. Patients randomized to fingolimod will need to have 6 hours of observation for signs and symptoms of bradycardia following administration of the first dose. Extended observation or overnight observation may be necessary under certain circumstances. Primary objective is to evaluate efficacy of fingolimod by assessing patients retention on treatment. Secondary objectives are to compare reasons for discontinuation, adverse events, cognitive impairment, medication satisfaction and change in brain volume measured by MRI. Exploratory objectives include annualized relapse rate, OCT, MRI evaluations, biomarkers and patient reported outcome measures.
Interventions
DRUGFingolimod
DRUGDisease Modifying therapy
Sponsors
Novartis Pharmaceuticals
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
1. written informed consent must be obtained prior to any assessment being performed. 2. Male and female patients aged 18-65 years inclusive. 3. Patients diagnosed with relapsing remitting MS, defined by the 2010 revised McDonald criteria (Pollman et al, 2011) (Appendix 1). 4. EDSS score of less than or equal to 6. 5. Patients naive to treatment or who have been treated with no more than one class of DMT previously (interferon β preparation or glatiramer acetate), and who, per investigator judgment, may benefit from a change of treatment class. 6. Patients who have been treated with DMF for less than 2 months total exposure and who have a normal lymphocyte count at screening. 7. Women of childbearing potential must have a negative urine and serum β-human chorionic gonadotropin (β-hCG) pregnancy test at screening and at baseline. 8. Before entry women must be: * Post menopausal for at least 1 year, or * Surgically sterile (have had a hysterectomy or bilateral oophorectomy, tubal ligation or otherwise incapable of pregnancy, or * Practicing a highly effective method of birth control if sexually active, including hormonal prescription oral contraceptives, contraceptive injections, contraceptive patch, intrauterine device, double barrier method (e.g., condoms, diaphragm or cervical cap with spermicidal foam, cream or gel), or male partner sterilization consistent with local regulations regarding use of birth control methods for patients participating in clinical trials, for the duration of their participation in the study, or * Not heterosexually active (patients who are not heterosexually active at screening must agree to utilize a highly effective method of birth control if they become heterosexually active during their participation in the study) 4.2
Exclusion criteria
<!-- --> 1. Use of other investigational drugs within 30 days of screening. 2. History of hypersensitivity to any of the study drugs or to drugs of similar chemical classes. 3. Prior exposure to fingolimod or any other S1P receptor modulating compounds. 4. History or presence of malignancy of any organ system (other than successfully treated basal or squamous cell carcinoma of the skin or stage 0 carcinoma of the cervix), treated or untreated, within the past 5 years, regardless of whether there is evidence of local recurrence or metastases. 5. Patients diagnosed with Secondary Progressive Multiple Sclerosis (SPMS) or Primary Progressive MS (PPMS). 6. Patients with a history of chronic disease of the immune system other than MS or a known immunodeficiency syndrome. 7. Patients who have been treated with: • Natalizumab, mitoxantrone, cladribine, rituximab, alemtuzumab, ofatumumab, ocrelizumab at any time before randomization • Immunoglobulins, or pulse of corticosteroids with more than 6 months cumulative exposure • Immunosuppressive/chemotherapeutic medications (e.g., methotrexate, azathioprine, cyclophosphamide, cellcept, Cytoxan, IVIG) with more than 6 months of cumulative exposure and within 6 months prior to randomization • Corticosteroids or adrenocorticotropic hormones in the past 30 days before randomization. Patients that require corticosteroids for a relapse during the screening period may be rescreened 30 days after the last dose. 8. History of treatment with both classes of approved first line DMT (interferon β preparation and glatiramer acetate) or DMF exposure of 2 months or longer. 9. Patients with uncontrolled diabetes mellitus (HbA1c \> 7%). 10. Diagnosis of macular edema during the screening phase. Patients with a history of macular edema will be allowed to enter the study provided that they do not have macular edema at the screening visit. 11. Patients with active systemic bacterial, viral or fungal infections, or known to have AIDS, Hepatitis B, Hepatitis C infection or positive HIV antibody, Hepatitis B surface antigen or Hepatitis C antibody tests. 12. Patients without history of chickenpox or without vaccination against varicella-zoster virus at screening (patients may be vaccinated and rescreened one month or longer after vaccination). 13. Patients who have received any live or live attenuated vaccines (including for varicella-zoster or measles) within 1 month prior to baseline. 14. Patients with any medically unstable condition as assessed by the investigator. 15. Patients with a history of the following cardiovascular conditions: • Cardiac arrest. • myocardial infarction, unstable angina, stroke, transient ischemic attack, decompensated heart failure requiring hospitalization, or Class III/IV heart failure (Appendix 3). • Congestive heart failure. • Hypertension that is not controlled with prescribed medications. These patients may be rescreened if blood pressure is stabilized with treatment. • Cerebrovascular disease. • History or presence of Mobitz Type II 2nd degree or 3rd degree AV block or sick sinus syndrome, unless patient has a pacemaker. • Patients at higher risk of symptomatic bradycardia or heart block because of a coexisting medical condition or certain concomitant medications. • Patients randomized to the fingolimod arm with prolonged QTc interval at screening (corrected QT interval \> 450 ms in males and \> 470 ms in females); for patients randomized to the fingolimod treatment arm before dosing (baseline) or during the 6-hour observation period; and those patients at additional risk for QT prolongation (e.g., hypokalemia, hypomagnesemia, congenital long-QT syndrome), or on a concomitant therapy with QT prolonging drugs with a known risk of Torsades de pointes (e.g., citalopram, chlorpromazine, haloperidol, methadone, erythromycin). * Patients receiving class Ia or Class III antiarrhythmic drugs (Appendix 6) * Patients receiving concurrent therapy with drugs that slow the heart rate or atrioventricular conduction (e.g., beta blockers, digoxin, or heart-rate slowing calcium channel blockers such as diltiazem, verapamil or digoxin). The possibility to switch to drugs that do not slow the heart rate or atrioventricular conduction should be evaluated by the physician prescribing these drugs before initiating fingolimod treatment. * History of sick sinus syndrome or sinoatrial heart block. * Resting heart rate of \< 45 bpm or symptomatic bradycardia * Recurrent syncope * Severe untreated sleep apnea 16. Patients with severe pulmonary conditions (including severe respiratory disease, pulmonary fibrosis, active tuberculosis, severe or poorly controlled asthma). 17. Patients with any of the following hepatic conditions: • Chronic liver or biliary disease * Total bilirubin greater than upper limit of normal (ULN) at screening unless in the context of Gilbert's syndrome * Conjugated bilirubin greater than the ULN at screening * AST (SGOT), ALT (SGPT) greater than 3 times ULN at screening * Alkaline phosphatase (AP) greater than 1.5 times the ULN at screening 18. Serum creatinine greater than 2.0 mg/dL (176.5 µmol/L) at screening. 19. Patients with the following neurological/psychiatric disorders: * History of substance abuse (drug or alcohol) in the past five years as determined by the investigator * Progressive neurological disorder other than MS which may affect study participation as determined by the investigator * Any serious psychiatric condition that may interfere with the patient's ability to cooperate and comply with the study procedures as determined by the investigator 20. Women who are pregnant or nursing (lactating) or planning to become pregnant. 21. Any condition that in the opinion of the investigator, would compromise the well-being of the patient or the conduct of the study, or prevent the patient from meeting or performing study requirements. 22. Pre-planned surgery or medical procedure that would interfere with the conduct of the study. 23. Employee of the sponsor, investigator or study center, with direct involvement in the proposed study or other studies under the direction of that investigator or study center, as well as family members of the employees or the investigator.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Participant Retention Rate Over 12 Months | at 12 months | Comparison effectiveness of fingolimod versus approved first-line disease modifying therapies by measuring the rate of participant retention on randomized treatment over a 12-month period (Full analysis set) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change From Baseline of Symbol Digit Modalities Test (SDMT) Scores (Oral Test) by Visit (Randomized Treatment / Randomized Phase) | baseline, 6 months, 12 months, and Last assessment which is either at Month 12 or at early discontinuation | Summary statistics Compare cognitive impairment measured by Symbol Digit Modalities Test (SDMT) scores. The SDMT score and its change from baseline value were summarized by visit. For the change from baseline values at each visit, ANCOVA adjusted for treatment naivety, corresponding baseline values, and age was performed for treatment comparisons The SDMT measures the time to pair abstract symbols with specific numbers. The test requires elements of attention, visuoperceptual processing, working memory, and psychomotor speed. The score is the number of correctly coded items from 0-110 in 90 seconds. The total score provides a measure of the speed and accuracy of symbol-digit substitution. NOTE: Higher scores indicate better performance. |
| Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | at 12 months | Reasons for discontinuation in participants treated with fingolimod vs. DMT over 12 months of treatment Total discontinued (Primary reason): Fingolimod arm: 27, MS-DMT arm: 27 = 54 participants Total discontinued (Secondary reason): Fingolimod arm: 257, MS-DMT arm: 256 = 513 participants Throughout the study, investigators evaluated each patient for occurrence of randomized treatment discontinuation and determined the primary and secondary reasons for such discontinuation. At every visit, the investigator evaluated the patients and determined if they should continue on randomized treatment or change to alternative treatment. Treatment discontinuation was a clinically meaningful measure related to safety, efficacy, and tolerability over time, reflecting the therapeutic effectiveness of study treatment. |
| Change From Baseline of Symbol Digit Modalities Test (SDMT) Scores (Written Test) by Visit (Randomized Treatment / Randomized Phase) | baseline, 6 months, 12 months, Last assessment which is either at Month 12 or at early discontinuation | Summary statistics Compare cognitive impairment measured by Symbol Digit Modalities Test (SDMT) scores. The SDMT score and its change from baseline value were summarized by visit. For the change from baseline values at each visit, ANCOVA adjusted for treatment naivety, corresponding baseline values, and age was performed for treatment comparisons The SDMT measures the time to pair abstract symbols with specific numbers. The test requires elements of attention, visuoperceptual processing, working memory, and psychomotor speed. The score is the number of correctly coded items from 0-110 in 90 seconds. The total score provides a measure of the speed and accuracy of symbol-digit substitution. NOTE: Higher scores indicate better performance. |
| Percent Change From Baseline in Brain Volume From Month 12 to Last Visit (Randomized) | 12 months, and Last assessment which is either at Month 12 or at early discontinuation | Summary statistics for percent change from month 12 in brain volume by visit (Randomized treatment / randomized phase) in patients treated with fingolimod vs.DMTs as measured by MRI |
| Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | Baseline, 1 month, 3 months, 6 months, 9 months, at 12 months & Last assessment during randomized phase which is either at Month 12 or at early discontinuation | Summary statistics for Medication Satisfaction Questionnaire\[Question: Overall, how satisfied are you with your current medication?\] (Randomized treatment / randomized phase): Fingolimod vs MS-DMT |
Countries
Puerto Rico, United States
Participant flow
Recruitment details
62 Fingolimod arm participants discontinued: 57 discontinued before treatment switch, and 5 discontinued after treatment switch 100 MS-DMT arm participants discontinued before treatment switch: 57 discontinued before treatment switch, and 43 discontinued after treatment switch
Pre-assignment details
Patient disposition was summarized on the Randomized Set. Randomized Set (RS): consists of all participants who were assigned randomization numbers.
Participants by arm
| Arm | Count |
|---|---|
| Fingolimod fingolimod 0.5 mg once a day | 436 |
| Disease Modifying Therapy (MS_DMT) 2 classes - Interferon Beta preparation (Exctavia, Betaseron, Rebif, Avonex) or glatiramer acetate (Copaxone) | 439 |
| Total | 875 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Abnormal laboratory values | 2 | 0 |
| Overall Study | Administrative problems | 9 | 13 |
| Overall Study | Adverse Event | 20 | 29 |
| Overall Study | Death | 0 | 2 |
| Overall Study | Lack of Efficacy | 5 | 3 |
| Overall Study | Lost to Follow-up | 12 | 16 |
| Overall Study | Patient no longer requires study drug | 1 | 0 |
| Overall Study | Protocol Violation | 0 | 6 |
| Overall Study | Withdrawal by Subject | 13 | 31 |
Baseline characteristics
| Characteristic | Fingolimod | Disease Modifying Therapy (MS_DMT) | Total |
|---|---|---|---|
| Age, Continuous | 41.5 years STANDARD_DEVIATION 10.84 | 41.9 years STANDARD_DEVIATION 10.39 | 41.7 years STANDARD_DEVIATION 10.61 |
| Sex: Female, Male Female | 311 Participants | 329 Participants | 640 Participants |
| Sex: Female, Male Male | 125 Participants | 110 Participants | 235 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — |
| other Total, other adverse events | 282 / 433 | 291 / 428 |
| serious Total, serious adverse events | 29 / 433 | 15 / 428 |
Outcome results
Primary
Participant Retention Rate Over 12 Months
Comparison effectiveness of fingolimod versus approved first-line disease modifying therapies by measuring the rate of participant retention on randomized treatment over a 12-month period (Full analysis set)
Time frame: at 12 months
Population: Full analysis set includes all the patients who received at least one dose of study medication and had information on the primary end point.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Fingolimod | Participant Retention Rate Over 12 Months | 352 participants |
| Disease Modifying Therapy (MS-DMT) | Participant Retention Rate Over 12 Months | 125 participants |
Secondary
Change From Baseline of Symbol Digit Modalities Test (SDMT) Scores (Oral Test) by Visit (Randomized Treatment / Randomized Phase)
Summary statistics Compare cognitive impairment measured by Symbol Digit Modalities Test (SDMT) scores. The SDMT score and its change from baseline value were summarized by visit. For the change from baseline values at each visit, ANCOVA adjusted for treatment naivety, corresponding baseline values, and age was performed for treatment comparisons The SDMT measures the time to pair abstract symbols with specific numbers. The test requires elements of attention, visuoperceptual processing, working memory, and psychomotor speed. The score is the number of correctly coded items from 0-110 in 90 seconds. The total score provides a measure of the speed and accuracy of symbol-digit substitution. NOTE: Higher scores indicate better performance.
Time frame: baseline, 6 months, 12 months, and Last assessment which is either at Month 12 or at early discontinuation
Population: Full analysis set includes all the patients who received at least one dose of study medication and had information on the primary end point.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Fingolimod | Change From Baseline of Symbol Digit Modalities Test (SDMT) Scores (Oral Test) by Visit (Randomized Treatment / Randomized Phase) | Baseline (n=76,70) | 52.00 SDMT score | Standard Deviation 12.12 |
| Fingolimod | Change From Baseline of Symbol Digit Modalities Test (SDMT) Scores (Oral Test) by Visit (Randomized Treatment / Randomized Phase) | Change at 6 months (n=70,64) | 2.20 SDMT score | Standard Deviation 8.09 |
| Fingolimod | Change From Baseline of Symbol Digit Modalities Test (SDMT) Scores (Oral Test) by Visit (Randomized Treatment / Randomized Phase) | Change at 12 months (n=58, 18) | 3.20 SDMT score | Standard Deviation 7.09 |
| Fingolimod | Change From Baseline of Symbol Digit Modalities Test (SDMT) Scores (Oral Test) by Visit (Randomized Treatment / Randomized Phase) | Change at Last assessment (n=73, 65) | 3.30 SDMT score | Standard Deviation 7.77 |
| Disease Modifying Therapy (MS-DMT) | Change From Baseline of Symbol Digit Modalities Test (SDMT) Scores (Oral Test) by Visit (Randomized Treatment / Randomized Phase) | Change at Last assessment (n=73, 65) | 0.40 SDMT score | Standard Deviation 9.47 |
| Disease Modifying Therapy (MS-DMT) | Change From Baseline of Symbol Digit Modalities Test (SDMT) Scores (Oral Test) by Visit (Randomized Treatment / Randomized Phase) | Baseline (n=76,70) | 51.60 SDMT score | Standard Deviation 13.4 |
| Disease Modifying Therapy (MS-DMT) | Change From Baseline of Symbol Digit Modalities Test (SDMT) Scores (Oral Test) by Visit (Randomized Treatment / Randomized Phase) | Change at 12 months (n=58, 18) | 1.40 SDMT score | Standard Deviation 8.33 |
| Disease Modifying Therapy (MS-DMT) | Change From Baseline of Symbol Digit Modalities Test (SDMT) Scores (Oral Test) by Visit (Randomized Treatment / Randomized Phase) | Change at 6 months (n=70,64) | 0.20 SDMT score | Standard Deviation 10.13 |
Secondary
Change From Baseline of Symbol Digit Modalities Test (SDMT) Scores (Written Test) by Visit (Randomized Treatment / Randomized Phase)
Summary statistics Compare cognitive impairment measured by Symbol Digit Modalities Test (SDMT) scores. The SDMT score and its change from baseline value were summarized by visit. For the change from baseline values at each visit, ANCOVA adjusted for treatment naivety, corresponding baseline values, and age was performed for treatment comparisons The SDMT measures the time to pair abstract symbols with specific numbers. The test requires elements of attention, visuoperceptual processing, working memory, and psychomotor speed. The score is the number of correctly coded items from 0-110 in 90 seconds. The total score provides a measure of the speed and accuracy of symbol-digit substitution. NOTE: Higher scores indicate better performance.
Time frame: baseline, 6 months, 12 months, Last assessment which is either at Month 12 or at early discontinuation
Population: Full analysis set includes all the patients who received at least one dose of study medication and had information on the primary end point.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Fingolimod | Change From Baseline of Symbol Digit Modalities Test (SDMT) Scores (Written Test) by Visit (Randomized Treatment / Randomized Phase) | Baseline (n=355,348) | 48.90 SDMT score | Standard Deviation 18.26 |
| Fingolimod | Change From Baseline of Symbol Digit Modalities Test (SDMT) Scores (Written Test) by Visit (Randomized Treatment / Randomized Phase) | Change at 12 months (n=282,105) | 0.70 SDMT score | Standard Deviation 16.02 |
| Fingolimod | Change From Baseline of Symbol Digit Modalities Test (SDMT) Scores (Written Test) by Visit (Randomized Treatment / Randomized Phase) | Change at 6 months (n=339,322) | -0.50 SDMT score | Standard Deviation 14.04 |
| Fingolimod | Change From Baseline of Symbol Digit Modalities Test (SDMT) Scores (Written Test) by Visit (Randomized Treatment / Randomized Phase) | Change at Last assessment (n=342, 324) | 0.80 SDMT score | Standard Deviation 16.27 |
| Disease Modifying Therapy (MS-DMT) | Change From Baseline of Symbol Digit Modalities Test (SDMT) Scores (Written Test) by Visit (Randomized Treatment / Randomized Phase) | Change at 6 months (n=339,322) | 0.70 SDMT score | Standard Deviation 13.16 |
| Disease Modifying Therapy (MS-DMT) | Change From Baseline of Symbol Digit Modalities Test (SDMT) Scores (Written Test) by Visit (Randomized Treatment / Randomized Phase) | Baseline (n=355,348) | 48.50 SDMT score | Standard Deviation 20.19 |
| Disease Modifying Therapy (MS-DMT) | Change From Baseline of Symbol Digit Modalities Test (SDMT) Scores (Written Test) by Visit (Randomized Treatment / Randomized Phase) | Change at Last assessment (n=342, 324) | 0.70 SDMT score | Standard Deviation 13.95 |
| Disease Modifying Therapy (MS-DMT) | Change From Baseline of Symbol Digit Modalities Test (SDMT) Scores (Written Test) by Visit (Randomized Treatment / Randomized Phase) | Change at 12 months (n=282,105) | 0.40 SDMT score | Standard Deviation 14.9 |
Secondary
Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score
Summary statistics for Medication Satisfaction Questionnaire\[Question: Overall, how satisfied are you with your current medication?\] (Randomized treatment / randomized phase): Fingolimod vs MS-DMT
Time frame: Baseline, 1 month, 3 months, 6 months, 9 months, at 12 months & Last assessment during randomized phase which is either at Month 12 or at early discontinuation
Population: Full analysis set (FAS) includes all the patients who received at least one dose of study medication and had information on the primary end point.
| Arm | Measure | Group | Value (NUMBER) | Dispersion |
|---|---|---|---|---|
| Fingolimod | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 1 month, Neither dissatisfied nor satisfied | 32 participants | 7.5 |
| Fingolimod | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 6 months, Missing | 36 participants | 0 |
| Fingolimod | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 9 months, Extremely dissatisfied | 7 participants | 1.9 |
| Fingolimod | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | Baseline, Extremely dissatisfied | 10 participants | 4.7 |
| Fingolimod | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | Baseline, Very dissatisfied | 22 participants | 10.3 |
| Fingolimod | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | Baseline, Somewhat dissatisfied | 29 participants | 13.6 |
| Fingolimod | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | Baseline, Neither dissatisfied nor satisfied | 62 participants | 29 |
| Fingolimod | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | Baseline, Somewhat satisfied | 35 participants | 16.4 |
| Fingolimod | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | Baseline, Very satisfied | 42 participants | 19.6 |
| Fingolimod | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | Baseline, Extremely satisfied | 14 participants | 6.5 |
| Fingolimod | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | Baseline, Missing | 219 participants | 0 |
| Fingolimod | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 1 month, Extremely dissatisfied | 8 participants | 1.9 |
| Fingolimod | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 1 month, Very dissatisfied | 14 participants | 3.3 |
| Fingolimod | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 1 month, Somewhat dissatisfied | 8 participants | 1.9 |
| Fingolimod | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 1 month, Somewhat satisfied | 52 participants | 12.1 |
| Fingolimod | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 1 month, Very satisfied | 161 participants | 37.5 |
| Fingolimod | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 1 month, Extremely satisfied | 154 participants | 35.9 |
| Fingolimod | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 1 month, Missing | 4 participants | 0 |
| Fingolimod | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 3 months, Extremely dissatisfied | 5 participants | 1.2 |
| Fingolimod | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 3 months, Very dissatisfied | 11 participants | 2.7 |
| Fingolimod | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 3 months, Somewhat dissatisfied | 11 participants | 2.7 |
| Fingolimod | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 3 months, Neither dissatisfied nor satisfied | 46 participants | 11.1 |
| Fingolimod | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 3 months, Somewhat satisfied | 43 participants | 10.4 |
| Fingolimod | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 3 months, Very satisfied | 153 participants | 37 |
| Fingolimod | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 3 months, Extremely satisfied | 144 participants | 34.9 |
| Fingolimod | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 3 months, Missing | 20 participants | 0 |
| Fingolimod | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 6 months, Extremely dissatisfied | 8 participants | 2 |
| Fingolimod | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 6 months, Very dissatisfied | 15 participants | 3.8 |
| Fingolimod | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 6 months, Somewhat dissatisfied | 11 participants | 2.8 |
| Fingolimod | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 6 months, Neither dissatisfied nor satisfied | 25 participants | 6.3 |
| Fingolimod | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 6 months, Somewhat satisfied | 57 participants | 14.4 |
| Fingolimod | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 6 months, Very satisfied | 130 participants | 32.7 |
| Fingolimod | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 6 months, Extremely satisfied | 151 participants | 38 |
| Fingolimod | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 9 months, Very dissatisfied | 8 participants | 2.2 |
| Fingolimod | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 9 months, Somewhat dissatisfied | 12 participants | 3.2 |
| Fingolimod | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 9 months, Neither dissatisfied nor satisfied | 21 participants | 5.7 |
| Fingolimod | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 9 months, Somewhat satisfied | 42 participants | 11.4 |
| Fingolimod | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 9 months, Very satisfied | 135 participants | 36.5 |
| Fingolimod | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 9 months, Extremely satisfied | 145 participants | 39.2 |
| Fingolimod | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 9 months, Missing | 63 participants | 0 |
| Fingolimod | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 12 months, Extremely dissatisfied | 7 participants | 2 |
| Fingolimod | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 12 months, Very dissatisfied | 7 participants | 2 |
| Fingolimod | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 12 months, Somewhat dissatisfied | 11 participants | 3.1 |
| Fingolimod | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 12 months, Neither dissatisfied nor satisfied | 27 participants | 7.7 |
| Fingolimod | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 12 months, Somewhat satisfied | 34 participants | 9.7 |
| Fingolimod | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 12 months, Very satisfied | 115 participants | 32.8 |
| Fingolimod | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 12 months, Extremely satisfied | 150 participants | 42.7 |
| Fingolimod | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 12 months, Missing | 82 participants | 0 |
| Fingolimod | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | Last assessment, Extremely dissatisfied | 14 participants | 3.3 |
| Fingolimod | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | Last assessment, Very dissatisfied | 15 participants | 3.5 |
| Fingolimod | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | Last assessment, Somewhat dissatisfied | 23 participants | 5.3 |
| Fingolimod | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | Last assessment,Neither dissatisfied nor satisfied | 45 participants | 10.5 |
| Fingolimod | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | Last assessment, Somewhat satisfied | 43 participants | 10 |
| Fingolimod | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | Last assessment, Very satisfied | 128 participants | 29.8 |
| Fingolimod | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | Last assessment, Extremely satisfied | 162 participants | 37.7 |
| Fingolimod | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | Last assessment, Missing | 3 participants | 0 |
| Disease Modifying Therapy (MS-DMT) | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 12 months, Very dissatisfied | 4 participants | 3.1 |
| Disease Modifying Therapy (MS-DMT) | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 6 months, Somewhat dissatisfied | 13 participants | 6.6 |
| Disease Modifying Therapy (MS-DMT) | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 6 months, Very dissatisfied | 11 participants | 5.6 |
| Disease Modifying Therapy (MS-DMT) | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 6 months, Missing | 232 participants | 0 |
| Disease Modifying Therapy (MS-DMT) | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | Last assessment, Somewhat satisfied | 69 participants | 16.4 |
| Disease Modifying Therapy (MS-DMT) | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 9 months, Extremely dissatisfied | 4 participants | 2.6 |
| Disease Modifying Therapy (MS-DMT) | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 9 months, Somewhat dissatisfied | 12 participants | 7.8 |
| Disease Modifying Therapy (MS-DMT) | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 12 months, Somewhat dissatisfied | 4 participants | 3.1 |
| Disease Modifying Therapy (MS-DMT) | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 6 months, Neither dissatisfied nor satisfied | 24 participants | 12.2 |
| Disease Modifying Therapy (MS-DMT) | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | Baseline, Very dissatisfied | 13 participants | 5.8 |
| Disease Modifying Therapy (MS-DMT) | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | Last assessment, Very dissatisfied | 61 participants | 14.5 |
| Disease Modifying Therapy (MS-DMT) | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | Baseline, Somewhat dissatisfied | 39 participants | 17.5 |
| Disease Modifying Therapy (MS-DMT) | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 6 months, Somewhat satisfied | 46 participants | 23.5 |
| Disease Modifying Therapy (MS-DMT) | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | Baseline, Neither dissatisfied nor satisfied | 61 participants | 27.4 |
| Disease Modifying Therapy (MS-DMT) | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 12 months, Neither dissatisfied nor satisfied | 8 participants | 6.3 |
| Disease Modifying Therapy (MS-DMT) | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | Baseline, Somewhat satisfied | 46 participants | 20.6 |
| Disease Modifying Therapy (MS-DMT) | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 6 months, Very satisfied | 67 participants | 34.2 |
| Disease Modifying Therapy (MS-DMT) | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | Baseline, Very satisfied | 31 participants | 13.9 |
| Disease Modifying Therapy (MS-DMT) | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | Last assessment, Extremely satisfied | 37 participants | 8.8 |
| Disease Modifying Therapy (MS-DMT) | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | Baseline, Extremely satisfied | 17 participants | 7.6 |
| Disease Modifying Therapy (MS-DMT) | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 6 months, Extremely satisfied | 26 participants | 13.3 |
| Disease Modifying Therapy (MS-DMT) | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | Baseline, Missing | 205 participants | 0 |
| Disease Modifying Therapy (MS-DMT) | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 12 months, Somewhat satisfied | 22 participants | 7.3 |
| Disease Modifying Therapy (MS-DMT) | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 1 month, Extremely dissatisfied | 29 participants | 6.9 |
| Disease Modifying Therapy (MS-DMT) | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 9 months, Very dissatisfied | 6 participants | 3.9 |
| Disease Modifying Therapy (MS-DMT) | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 1 month, Very dissatisfied | 37 participants | 8.9 |
| Disease Modifying Therapy (MS-DMT) | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | Last assessment, Somewhat dissatisfied | 57 participants | 13.5 |
| Disease Modifying Therapy (MS-DMT) | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 1 month, Somewhat dissatisfied | 52 participants | 12.4 |
| Disease Modifying Therapy (MS-DMT) | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | Baseline, Extremely dissatisfied | 16 participants | 7.2 |
| Disease Modifying Therapy (MS-DMT) | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 1 month, Neither dissatisfied nor satisfied | 74 participants | 17.7 |
| Disease Modifying Therapy (MS-DMT) | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 12 months, Very satisfied | 60 participants | 47.2 |
| Disease Modifying Therapy (MS-DMT) | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 1 month, Somewhat satisfied | 89 participants | 21.3 |
| Disease Modifying Therapy (MS-DMT) | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 9 months, Neither dissatisfied nor satisfied | 15 participants | 9.8 |
| Disease Modifying Therapy (MS-DMT) | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 1 month, Very satisfied | 97 participants | 23.2 |
| Disease Modifying Therapy (MS-DMT) | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | Last assessment, Very satisfied | 94 participants | 22.3 |
| Disease Modifying Therapy (MS-DMT) | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 1 month, Extremely satisfied | 40 participants | 9.6 |
| Disease Modifying Therapy (MS-DMT) | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 9 months, Somewhat satisfied | 29 participants | 19 |
| Disease Modifying Therapy (MS-DMT) | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 1 month, Missing | 10 participants | 0 |
| Disease Modifying Therapy (MS-DMT) | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 12 months, Extremely satisfied | 26 participants | 20.5 |
| Disease Modifying Therapy (MS-DMT) | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 3 months, Extremely dissatisfied | 19 participants | 5.5 |
| Disease Modifying Therapy (MS-DMT) | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 9 months, Very satisfied | 58 participants | 37.9 |
| Disease Modifying Therapy (MS-DMT) | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 3 months, Very dissatisfied | 38 participants | 11 |
| Disease Modifying Therapy (MS-DMT) | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | Last assessment,Neither dissatisfied nor satisfied | 58 participants | 13.7 |
| Disease Modifying Therapy (MS-DMT) | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 3 months, Somewhat dissatisfied | 42 participants | 12.1 |
| Disease Modifying Therapy (MS-DMT) | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 9 months, Extremely satisfied | 29 participants | 19 |
| Disease Modifying Therapy (MS-DMT) | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 3 months, Neither dissatisfied nor satisfied | 53 participants | 15.3 |
| Disease Modifying Therapy (MS-DMT) | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 12 months, Missing | 301 participants | 0 |
| Disease Modifying Therapy (MS-DMT) | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 3 months, Somewhat satisfied | 73 participants | 21.1 |
| Disease Modifying Therapy (MS-DMT) | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 9 months, Missing | 275 participants | 0 |
| Disease Modifying Therapy (MS-DMT) | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 3 months, Very satisfied | 91 participants | 26.3 |
| Disease Modifying Therapy (MS-DMT) | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | Last assessment, Missing | 6 participants | 0 |
| Disease Modifying Therapy (MS-DMT) | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 3 months, Extremely satisfied | 30 participants | 8.7 |
| Disease Modifying Therapy (MS-DMT) | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 12 months, Extremely dissatisfied | 3 participants | 2.4 |
| Disease Modifying Therapy (MS-DMT) | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 3 months, Missing | 82 participants | 0 |
| Disease Modifying Therapy (MS-DMT) | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | Last assessment, Extremely dissatisfied | 46 participants | 10.9 |
| Disease Modifying Therapy (MS-DMT) | Number of Satisfied Participants Per Medication Satisfaction Questionnaire (MSQ) Score | 6 months, Extremely dissatisfied | 9 participants | 4.6 |
Secondary
Percent Change From Baseline in Brain Volume From Month 12 to Last Visit (Randomized)
Summary statistics for percent change from month 12 in brain volume by visit (Randomized treatment / randomized phase) in patients treated with fingolimod vs.DMTs as measured by MRI
Time frame: 12 months, and Last assessment which is either at Month 12 or at early discontinuation
Population: Full analysis set includes all the patients who received at least one dose of study medication and had information on the primary end point.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Fingolimod | Percent Change From Baseline in Brain Volume From Month 12 to Last Visit (Randomized) | Percent change at 12 months (n=323, 111) | -0.396 percent change in brain volume | Standard Deviation 0.7825 |
| Fingolimod | Percent Change From Baseline in Brain Volume From Month 12 to Last Visit (Randomized) | Percent change at Last assessment (n=370, 246) | -0.385 percent change in brain volume | Standard Deviation 0.769 |
| Disease Modifying Therapy (MS-DMT) | Percent Change From Baseline in Brain Volume From Month 12 to Last Visit (Randomized) | Percent change at 12 months (n=323, 111) | -0.555 percent change in brain volume | Standard Deviation 0.7181 |
| Disease Modifying Therapy (MS-DMT) | Percent Change From Baseline in Brain Volume From Month 12 to Last Visit (Randomized) | Percent change at Last assessment (n=370, 246) | -0.420 percent change in brain volume | Standard Deviation 0.6423 |
Secondary
Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set
Reasons for discontinuation in participants treated with fingolimod vs. DMT over 12 months of treatment Total discontinued (Primary reason): Fingolimod arm: 27, MS-DMT arm: 27 = 54 participants Total discontinued (Secondary reason): Fingolimod arm: 257, MS-DMT arm: 256 = 513 participants Throughout the study, investigators evaluated each patient for occurrence of randomized treatment discontinuation and determined the primary and secondary reasons for such discontinuation. At every visit, the investigator evaluated the patients and determined if they should continue on randomized treatment or change to alternative treatment. Treatment discontinuation was a clinically meaningful measure related to safety, efficacy, and tolerability over time, reflecting the therapeutic effectiveness of study treatment.
Time frame: at 12 months
Population: Randomized set (RS): consists of all patients who were assigned randomization numbers.~The patients in this set were called randomized patients. This set was used to summarize patient disposition, demographic and baseline characteristics, and protocol deviation information. Patients were grouped according to randomized treatment.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Fingolimod | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Depression (Primary reason) | 1 participants |
| Fingolimod | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Flu-like symptoms (Secondary reason) | 1 participants |
| Fingolimod | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Hepatic side effects (Primary reason) | 7 participants |
| Fingolimod | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Inconvenient administration (Secondary reason) | 0 participants |
| Fingolimod | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Spasticity (Primary reason) | 0 participants |
| Fingolimod | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Spasticity (Secondary reason) | 1 participants |
| Fingolimod | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Infection (Primary reason) | 0 participants |
| Fingolimod | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Frequency of injections (Secondary reason) | 0 participants |
| Fingolimod | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Macular edema (Primary reason) | 1 participants |
| Fingolimod | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Neutralizing antibodies present (Secondary reason) | 0 participants |
| Fingolimod | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Bradycardia (Primary reason) | 0 participants |
| Fingolimod | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Depression (Secondary reason) | 0 participants |
| Fingolimod | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Needle phobia (Primary reason) | 0 participants |
| Fingolimod | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Occurrence of relapse (Primary reason) | 5 participants |
| Fingolimod | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Inconvenient administration (Primary reason) | 0 participants |
| Fingolimod | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Infection (Secondary reason) | 0 participants |
| Fingolimod | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Frequency of injections (Primary reason) | 0 participants |
| Fingolimod | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Disease activity present in MRI (Primary reason) | 0 participants |
| Fingolimod | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Neutralizing antibodies present (Primary reason) | 0 participants |
| Fingolimod | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Lipoatrophy (Secondary reason) | 0 participants |
| Fingolimod | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Other (Primary reason) | 13 participants |
| Fingolimod | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Injection site reaction (Primary reason) | 0 participants |
| Fingolimod | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Occurrence of relapse (Secondary reason) | 0 participants |
| Fingolimod | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Macular edema (Secondary reason) | 1 participants |
| Fingolimod | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Disease activity present in MRI (Secondary reason) | 2 participants |
| Fingolimod | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Flu-like symptoms (Primary reason) | 0 participants |
| Fingolimod | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Hepatic side effects (Secondary reason) | 5 participants |
| Fingolimod | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Bradycardia (Secondary reason) | 0 participants |
| Fingolimod | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Lipoatrophy (Primary reason) | 0 participants |
| Fingolimod | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Needle phobia (Secondary reason) | 0 participants |
| Fingolimod | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Other (Secondary reason) | 17 participants |
| Fingolimod | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Injection site reaction (Secondary reason) | 0 participants |
| Disease Modifying Therapy (MS-DMT) | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Other (Secondary reason) | 65 participants |
| Disease Modifying Therapy (MS-DMT) | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Injection site reaction (Secondary reason) | 40 participants |
| Disease Modifying Therapy (MS-DMT) | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Lipoatrophy (Secondary reason) | 1 participants |
| Disease Modifying Therapy (MS-DMT) | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Depression (Secondary reason) | 6 participants |
| Disease Modifying Therapy (MS-DMT) | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Hepatic side effects (Secondary reason) | 0 participants |
| Disease Modifying Therapy (MS-DMT) | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Spasticity (Secondary reason) | 2 participants |
| Disease Modifying Therapy (MS-DMT) | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Infection (Secondary reason) | 0 participants |
| Disease Modifying Therapy (MS-DMT) | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Macular edema (Secondary reason) | 0 participants |
| Disease Modifying Therapy (MS-DMT) | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Needle phobia (Secondary reason) | 18 participants |
| Disease Modifying Therapy (MS-DMT) | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Inconvenient administration (Secondary reason) | 55 participants |
| Disease Modifying Therapy (MS-DMT) | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Neutralizing antibodies present (Secondary reason) | 0 participants |
| Disease Modifying Therapy (MS-DMT) | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Occurrence of relapse (Primary reason) | 14 participants |
| Disease Modifying Therapy (MS-DMT) | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Disease activity present in MRI (Primary reason) | 6 participants |
| Disease Modifying Therapy (MS-DMT) | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Injection site reaction (Primary reason) | 61 participants |
| Disease Modifying Therapy (MS-DMT) | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Flu-like symptoms (Primary reason) | 34 participants |
| Disease Modifying Therapy (MS-DMT) | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Lipoatrophy (Primary reason) | 1 participants |
| Disease Modifying Therapy (MS-DMT) | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Depression (Primary reason) | 4 participants |
| Disease Modifying Therapy (MS-DMT) | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Hepatic side effects (Primary reason) | 3 participants |
| Disease Modifying Therapy (MS-DMT) | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Spasticity (Primary reason) | 1 participants |
| Disease Modifying Therapy (MS-DMT) | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Infection (Primary reason) | 0 participants |
| Disease Modifying Therapy (MS-DMT) | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Macular edema (Primary reason) | 0 participants |
| Disease Modifying Therapy (MS-DMT) | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Bradycardia (Primary reason) | 0 participants |
| Disease Modifying Therapy (MS-DMT) | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Needle phobia (Primary reason) | 13 participants |
| Disease Modifying Therapy (MS-DMT) | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Inconvenient administration (Primary reason) | 33 participants |
| Disease Modifying Therapy (MS-DMT) | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Frequency of injections (Primary reason) | 29 participants |
| Disease Modifying Therapy (MS-DMT) | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Neutralizing antibodies present (Primary reason) | 0 participants |
| Disease Modifying Therapy (MS-DMT) | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Other (Primary reason) | 58 participants |
| Disease Modifying Therapy (MS-DMT) | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Occurrence of relapse (Secondary reason) | 3 participants |
| Disease Modifying Therapy (MS-DMT) | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Disease activity present in MRI (Secondary reason) | 5 participants |
| Disease Modifying Therapy (MS-DMT) | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Flu-like symptoms (Secondary reason) | 16 participants |
| Disease Modifying Therapy (MS-DMT) | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Bradycardia (Secondary reason) | 0 participants |
| Disease Modifying Therapy (MS-DMT) | Primary and Secondary Reasons for Discontinuation From Randomized Treatment: Randomized Set | Frequency of injections (Secondary reason) | 45 participants |