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News
When it comes to slowing relapse-independent disability progression in multiple sclerosis, platform DMTs appear to be on equal footing. A large Italian study found no meaningful difference between oral and injectable platform disease-modifying therapies in preventing progression independent of relapse activity (PIRA) in RRMS patients. So, the choice between them should come down to patient-specific factors like tolerability and lifestyle.
A large retrospective study out of Italy has found that among patients with relapsing-remitting multiple sclerosis (RRMS), oral and injectable platform disease-modifying therapies (DMTs) perform similarly when it comes to preventing progression independent of relapse activity (PIRA) — a key marker of long-term disability accumulation. The study analyzed over 1,900 patients treated continuously for at least five years with one of four platform DMTs: dimethyl fumarate, teriflunomide, interferon beta, or glatiramer acetate.
Whether researchers compared oral vs. oral, injectable vs. injectable, or oral vs. injectable, no significant differences emerged in either the number of PIRA events or the time to first PIRA event. These findings held up even in expanded analyses that removed the five-year treatment duration requirement.
Key Takeaways:
Why it matters: Since none of these platform DMTs show a clear advantage in preventing relapse-independent progression, clinicians should lean on other factors — tolerability, safety profile, route of administration, patient comorbidities, and personal preferences — when tailoring treatment decisions for RRMS patients.
