In:
Multiple Sclerosis Journal, SAGE Publications, Vol. 27, No. 10 ( 2021-09), p. 1564-1576
Kurzfassung:
In multiple sclerosis, impact of treatment on disability progression can be confounded if treatment also reduces relapses. Objective: To distinguish siponimod’s direct effects on disability progression from those on relapses in the EXPAND phase 3 trial. Methods: Three estimands, one based on principal stratum and two on hypothetical scenarios (no relapses, or equal relapses in both treatment arms), were defined to determine the extent to which siponimod’s effects on 3- and 6-month confirmed disability progression were independent of on-study relapses. Results: Principal stratum analysis estimated that siponimod reduced the risk of 3- and 6-month confirmed disability progression by 14%–20% and 29%–33%, respectively, compared with placebo in non-relapsing patients. In the hypothetical scenarios, risk reductions independent of relapses were 14%–18% and 23% for 3- and 6-month confirmed disability progression, respectively. Conclusion: By controlling the confounding impact of on-study relapses on confirmed disability progression, these statistical approaches provide a methodological framework to assess treatment effects on disability progression in relapsing and non-relapsing patients. The analyses support that siponimod may be useful for treating secondary progressive multiple sclerosis in patients with or without relapses.
Materialart:
Online-Ressource
ISSN:
1352-4585
,
1477-0970
DOI:
10.1177/1352458520971819
Sprache:
Englisch
Verlag:
SAGE Publications
Publikationsdatum:
2021
ZDB Id:
2008225-3