• Meryem Aslı Tuncer, Murat Kürtüncü, Murat Terzi, Uğur Uygunoğlu, Cansu Göncüoğlu, Ayşe Nur Yüceyar, Özgül Ekmekçi, Recai Türkoğlu, Aysun Soysal, Mesrure Köseoğlu, Cavit Boz, Yeşim Beckmann, Ömer Faruk Turan, Duruhan Meltem Demirkıran, Firdevs Gülşen Akman, Burcu Altunrende, İlknur Aydın Cantürk, Erkingül Birday, Abdulcemal Özcan, Özden Kamişli, Nazire Pinar Acar Özen, Rabia Gökçen Gözübatik Çelik, Fatma Belgin Balcı, Hüsnü Efendi, Cansu Sarıkaya, Aylin Akçalı, Münire Kılınç Toprak, KabaySibel CanbazSCDepartment of Neurology, Faculty of Medicine, Kütahya Health Sciences University, Kütahya, Turkey., Ferah Kızılay, Mustafa Serhan Sevim, Gülcan Baran Gazaloğlu, Caner Feyzi Demir, Ferhat Balgetir, Nefati Kıylıoğlu, Hande Sarıahmetoğlu, Çağcan Ölmez, Kamil Mavi, Süha Yüksel, Nihal Işık, Sabahattin Saip, Rana Karabudak, Aksel Siva, and Mefküre Eraksoy.
• Department of Neurology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
• Turk J Med Sci. 2023 Feb 1; 53 (1): 323332323-332.

BackgroundDuring multiple sclerosis (MS) treatment different modes of action such as lateral (interferon beta to glatiramer acetate or glatiramer acetate to interferon beta) or vertical (interferon beta/glatiramer acetate to fingolimod) drug switch can be performed. This study aims to investigate the clinical effectiveness of switching from the first-line injectable disease modifying treatments (iDMTs) to fingolimod (FNG) compared to switching between first-line iDMTs.MethodsThis is a multicenter, observational and retrospective study of patients with relapsing-remitting MS who had lateral and vertical switch. The observation period included three key assessment time points (before the switch, at switch, and after the switch). Data were collected from the MS patients' database by neurologists between January 2018 and June 2019. The longest follow-up period of the patients was determined as 24 months after the switch.ResultsIn 462 MS patients that were included in the study, both treatments significantly decreased the number of relapses during the postswitch 12 months versus preswitch one year while patients in the FNG group experienced significantly fewer relapses compared to iDMT cohort in the postswitch 12 months period. FNG cohort experienced fewer relapses than in the iDMT cohort within the postswitch 2 year. The mean time to first relapse after the switch was significantly longer in the FNG group.DiscussionThe present study revealed superior effectiveness of vertical switch over lateral switch regarding the improvement in relapse outcomes. Patients in the FNG cohort experienced sustainably fewer relapses during the follow-up period after the switch compared the iDMT cohort. Importantly, switching to FNG was more effective in delaying time to first relapse when compared with iDMTs.

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