Five-Year Follow-up of Delayed-Release Dimethyl Fumarate in RRMS: Integrated Clinical Efficacy Data from the DEFINE, CONFIRM, and ENDORSE Studies (P7.234)
Bibliographic record
Abstract
OBJECTIVE: To report long-term (5-year minimum follow-up) clinical efficacy outcomes with delayed-release dimethyl fumarate (DMF; also known as gastro-resistant DMF) in patients with relapsing-remitting multiple sclerosis (RRMS). BACKGROUND: DMF demonstrated broad efficacy and an acceptable safety profile in RRMS patients in the phase 3 DEFINE and CONFIRM studies; ENDORSE is an 8-year extension of DEFINE/CONFIRM. DESIGN/METHODS: Patients randomized to DMF 240 mg twice (BID) or three times daily (TID) in DEFINE/CONFIRM continued the same dosage in ENDORSE. Patients randomized to placebo (PBO; DEFINE/CONFIRM) or glatiramer acetate (GA; CONFIRM) were re-randomized 1:1 to DMF 240 mg BID or TID. Data were analyzed (May 14, 2014 cutoff) by treatment arm in parent/extension study: BID/BID, TID/TID, PBO/BID, PBO/TID, GA/BID, GA/TID. Results for DMF 240 mg BID are reported, as this represents the maintenance dosage of DMF approved for treatment of patients with relapsing MS. RESULTS: Of 2,079 patients completing DEFINE/CONFIRM, 1,736 were dosed in ENDORSE (n=501 [BID/BID], 502 [TID/TID], 249 [PBO/BID], 248 [PBO/TID], 118 [GA/BID], 118 [GA/TID]). Adjusted annualized relapse rates (ARRs) (95[percnt] confidence interval [CI]) for BID/BID during Years 1 and 2 (DEFINE/CONFIRM) and Years 3, 4, and 5 (ENDORSE) were 0.202 (0.162-0.252), 0.163 (0.128-0.208), 0.139 (0.105-0.184), 0.143 (0.109-0.188), and 0.138 (0.104- 0.183), respectively. For patients switching treatment from PBO or GA, the ARRs (95[percnt] CI) during Years 3, 4, and 5 were 0.176 (0.121-0.255), 0.131 (0.086-0.198), and 0.107 (0.068- 0.171) for PBO/BID and 0.182 (0.109-0.302), 0.137 (0.077-0.245), and 0.118 (0.062-0.225) for GA/BID, respectively. Estimated probability of disability progression remained low among patients continuing DMF. CONCLUSIONS: Treatment with DMF was associated with low relapse rates and estimated probability of disability progression over 5 years; these results support its use as a long-term treatment option for patients with RRMS. Study Supported by: Biogen Idec
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.012 | 0.007 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".