Impact of a switch to fingolimod on depressive symptoms in patients with relapsing multiple sclerosis: An analysis from the EPOC (Evaluate Patient OutComes) trial

Samuel F. Hunter, Mark Agius, Deborah M. Miller, Gary Cutter, Luigi Barbato, Kevin McCague, Xiangyi Meng, Neetu Agashivala, Peter Chin, Eric Hollander

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background Depression is common in patients with multiple sclerosis (MS), may confound evaluation of therapeutic effectiveness and may be impacted by MS-specific treatments. Objective First, to assess the impact on depressive symptoms of a switch to fingolimod versus remaining on an injectable disease-modifying therapy (iDMT) in a post-hoc analysis of prospectively collected data from the EPOC study. Secondly, to investigate the underlying Beck Depression Inventory-II (BDI-II) factor structure in patients with MS, and estimate treatment differences using the resulting subscales. Methods EPOC was a 6-month, open-label study assessing patient-reported outcomes after switch from iDMT to oral fingolimod 0.5 mg versus remaining on iDMT in 1053 patients with relapsing-remitting MS. Results At end of study (EOS), a greater proportion of patients on fingolimod versus iDMT no longer had BDI-II scores indicating depression (p <0.001). Fewer mildly and moderately symptomatic patients developed severe depressive symptoms, and fewer severely symptomatic patients continued to have scores indicating severe depression at EOS on fingolimod versus iDMT (p = 0.027, p = 0.038, p = 0.030, respectively). Two BDI-II subscales were identified and labelled Somatic and Affective; fingolimod demonstrated more reduction on both subscales at EOS versus iDMTs (p <0.0001 and p = 0.0001, respectively). Conclusion A switch to fingolimod versus remaining on/switching to another iDMT was associated with an improvement in depressive symptoms in patients with relapsing-remitting MS.

Original languageEnglish (US)
Pages (from-to)190-198
Number of pages9
JournalJournal of the Neurological Sciences
Volume365
DOIs
StatePublished - Jun 15 2016

Fingerprint

Multiple Sclerosis
Depression
Injections
Relapsing-Remitting Multiple Sclerosis
Therapeutics
Equipment and Supplies
Fingolimod Hydrochloride
Outcome Assessment (Health Care)

Keywords

  • BDI-II
  • Depression
  • Fingolimod
  • Multiple sclerosis
  • Patient-reported outcomes
  • Satisfaction

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

Cite this

Impact of a switch to fingolimod on depressive symptoms in patients with relapsing multiple sclerosis : An analysis from the EPOC (Evaluate Patient OutComes) trial. / Hunter, Samuel F.; Agius, Mark; Miller, Deborah M.; Cutter, Gary; Barbato, Luigi; McCague, Kevin; Meng, Xiangyi; Agashivala, Neetu; Chin, Peter; Hollander, Eric.

In: Journal of the Neurological Sciences, Vol. 365, 15.06.2016, p. 190-198.

Research output: Contribution to journalArticle

Hunter, Samuel F. ; Agius, Mark ; Miller, Deborah M. ; Cutter, Gary ; Barbato, Luigi ; McCague, Kevin ; Meng, Xiangyi ; Agashivala, Neetu ; Chin, Peter ; Hollander, Eric. / Impact of a switch to fingolimod on depressive symptoms in patients with relapsing multiple sclerosis : An analysis from the EPOC (Evaluate Patient OutComes) trial. In: Journal of the Neurological Sciences. 2016 ; Vol. 365. pp. 190-198.
@article{fd4a0b1a46584e169a49c2f71aa02367,
title = "Impact of a switch to fingolimod on depressive symptoms in patients with relapsing multiple sclerosis: An analysis from the EPOC (Evaluate Patient OutComes) trial",
abstract = "Background Depression is common in patients with multiple sclerosis (MS), may confound evaluation of therapeutic effectiveness and may be impacted by MS-specific treatments. Objective First, to assess the impact on depressive symptoms of a switch to fingolimod versus remaining on an injectable disease-modifying therapy (iDMT) in a post-hoc analysis of prospectively collected data from the EPOC study. Secondly, to investigate the underlying Beck Depression Inventory-II (BDI-II) factor structure in patients with MS, and estimate treatment differences using the resulting subscales. Methods EPOC was a 6-month, open-label study assessing patient-reported outcomes after switch from iDMT to oral fingolimod 0.5 mg versus remaining on iDMT in 1053 patients with relapsing-remitting MS. Results At end of study (EOS), a greater proportion of patients on fingolimod versus iDMT no longer had BDI-II scores indicating depression (p <0.001). Fewer mildly and moderately symptomatic patients developed severe depressive symptoms, and fewer severely symptomatic patients continued to have scores indicating severe depression at EOS on fingolimod versus iDMT (p = 0.027, p = 0.038, p = 0.030, respectively). Two BDI-II subscales were identified and labelled Somatic and Affective; fingolimod demonstrated more reduction on both subscales at EOS versus iDMTs (p <0.0001 and p = 0.0001, respectively). Conclusion A switch to fingolimod versus remaining on/switching to another iDMT was associated with an improvement in depressive symptoms in patients with relapsing-remitting MS.",
keywords = "BDI-II, Depression, Fingolimod, Multiple sclerosis, Patient-reported outcomes, Satisfaction",
author = "Hunter, {Samuel F.} and Mark Agius and Miller, {Deborah M.} and Gary Cutter and Luigi Barbato and Kevin McCague and Xiangyi Meng and Neetu Agashivala and Peter Chin and Eric Hollander",
year = "2016",
month = "6",
day = "15",
doi = "10.1016/j.jns.2016.03.024",
language = "English (US)",
volume = "365",
pages = "190--198",
journal = "Journal of the Neurological Sciences",
issn = "0022-510X",
publisher = "Elsevier",

}

TY - JOUR

T1 - Impact of a switch to fingolimod on depressive symptoms in patients with relapsing multiple sclerosis

T2 - An analysis from the EPOC (Evaluate Patient OutComes) trial

AU - Hunter, Samuel F.

AU - Agius, Mark

AU - Miller, Deborah M.

AU - Cutter, Gary

AU - Barbato, Luigi

AU - McCague, Kevin

AU - Meng, Xiangyi

AU - Agashivala, Neetu

AU - Chin, Peter

AU - Hollander, Eric

PY - 2016/6/15

Y1 - 2016/6/15

N2 - Background Depression is common in patients with multiple sclerosis (MS), may confound evaluation of therapeutic effectiveness and may be impacted by MS-specific treatments. Objective First, to assess the impact on depressive symptoms of a switch to fingolimod versus remaining on an injectable disease-modifying therapy (iDMT) in a post-hoc analysis of prospectively collected data from the EPOC study. Secondly, to investigate the underlying Beck Depression Inventory-II (BDI-II) factor structure in patients with MS, and estimate treatment differences using the resulting subscales. Methods EPOC was a 6-month, open-label study assessing patient-reported outcomes after switch from iDMT to oral fingolimod 0.5 mg versus remaining on iDMT in 1053 patients with relapsing-remitting MS. Results At end of study (EOS), a greater proportion of patients on fingolimod versus iDMT no longer had BDI-II scores indicating depression (p <0.001). Fewer mildly and moderately symptomatic patients developed severe depressive symptoms, and fewer severely symptomatic patients continued to have scores indicating severe depression at EOS on fingolimod versus iDMT (p = 0.027, p = 0.038, p = 0.030, respectively). Two BDI-II subscales were identified and labelled Somatic and Affective; fingolimod demonstrated more reduction on both subscales at EOS versus iDMTs (p <0.0001 and p = 0.0001, respectively). Conclusion A switch to fingolimod versus remaining on/switching to another iDMT was associated with an improvement in depressive symptoms in patients with relapsing-remitting MS.

AB - Background Depression is common in patients with multiple sclerosis (MS), may confound evaluation of therapeutic effectiveness and may be impacted by MS-specific treatments. Objective First, to assess the impact on depressive symptoms of a switch to fingolimod versus remaining on an injectable disease-modifying therapy (iDMT) in a post-hoc analysis of prospectively collected data from the EPOC study. Secondly, to investigate the underlying Beck Depression Inventory-II (BDI-II) factor structure in patients with MS, and estimate treatment differences using the resulting subscales. Methods EPOC was a 6-month, open-label study assessing patient-reported outcomes after switch from iDMT to oral fingolimod 0.5 mg versus remaining on iDMT in 1053 patients with relapsing-remitting MS. Results At end of study (EOS), a greater proportion of patients on fingolimod versus iDMT no longer had BDI-II scores indicating depression (p <0.001). Fewer mildly and moderately symptomatic patients developed severe depressive symptoms, and fewer severely symptomatic patients continued to have scores indicating severe depression at EOS on fingolimod versus iDMT (p = 0.027, p = 0.038, p = 0.030, respectively). Two BDI-II subscales were identified and labelled Somatic and Affective; fingolimod demonstrated more reduction on both subscales at EOS versus iDMTs (p <0.0001 and p = 0.0001, respectively). Conclusion A switch to fingolimod versus remaining on/switching to another iDMT was associated with an improvement in depressive symptoms in patients with relapsing-remitting MS.

KW - BDI-II

KW - Depression

KW - Fingolimod

KW - Multiple sclerosis

KW - Patient-reported outcomes

KW - Satisfaction

UR - http://www.scopus.com/inward/record.url?scp=84964466784&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84964466784&partnerID=8YFLogxK

U2 - 10.1016/j.jns.2016.03.024

DO - 10.1016/j.jns.2016.03.024

M3 - Article

C2 - 27206905

AN - SCOPUS:84964466784

VL - 365

SP - 190

EP - 198

JO - Journal of the Neurological Sciences

JF - Journal of the Neurological Sciences

SN - 0022-510X

ER -