Abstract Details

Title Comparative effectiveness of natalizumab and fingolimod in subgroups of patients with relapsing-remitting multiple sclerosis from three international cohorts

Topic Multiple Sclerosis

Presentation(s) MS and CNS Inflammatory Disease Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 073

Objective

To compare the relative treatment effects of natalizumab and fingolimod in subgroups with relapsing-remitting multiple sclerosis (RRMS).

Background

Natalizumab has proved to be more effective than fingolimod in reducing disease activity in RRMS. Whether this association is universal for all patient groups remains to be determined.

Design/Methods

RRMS patients from three international registries who were given natalizumab or fingolimod were stratified based on sex, age, disease duration, expanded disability status scale (EDSS) score, presence of relapses or disability worsening, and MRI activity 12 months prior to treatment initiation. Study outcomes were number of relapses and cumulative hazards of first relapse, 6-month confirmed disability worsening and improvement events, recorded during study therapy.

Results

A total of 5,148 patients (natalizumab: 1,989; fingolimod: 3,159) were included with mean age at baseline of 37.91 (SD 10.07) years and majority (71.83%) female. The median on-treatment follow-up was 25.05 (quartiles 14.92-40.89) months. Natalizumab was associated with fewer relapses compared to fingolimod (incidence rate ratio, IRR [95% CI]) in females (0.76 [0.65-0.88]); age group≤38 years (0.64 [0.54-0.76]); disease duration≤7 years (0.63 [0.53-0.76]); EDSS score?4 (0.75 [0.64-0.88]); ?6 (0.80 [0.70-0.91]); ≥6 (0.52 [0.31-0.86]); and patients with pre-baseline relapses (0.74 [0.64-0.86]). Natalizumab was also more efficacious regardless of absence (0.62 [0.49-0.77]) or presence (0.46 [0.35-0.61]) of new MRI lesion within the year before treatment initiation. Higher probability of confirmed disability improvement on natalizumab vs. fingolimod (hazard ratio, HR [95% CI]) was observed among females (1.36 [1.10-1.66]); age group>38 years (1.34 [1.04-1.73]); disease duration?7 years (1.33 [1.01-1.74]); EDSS score?6 (1.21 [1.01-1.46]) and ≥6 (1.93 [1.11-3.34]); and patients with no new MRI lesions (1.73 [1.19-2.51]).

Conclusions

Natalizumab is associated with lower relapse frequency and higher chance of improvement in disability than fingolimod, which is most pronounced in females, patients with lower disability, and with pre-treatment relapses.

Authors/Disclosures
Tomas Kalincik PRESENTER	Tomas Kalincik has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Roche. Tomas Kalincik has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi Genzyme. Tomas Kalincik has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. Tomas Kalincik has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Merck. Tomas Kalincik has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. Tomas Kalincik has received personal compensation in the range of $500-$4,999 for serving as a Consultant for National Health and Medical Research Council. Tomas Kalincik has received personal compensation in the range of $500-$4,999 for serving as a Consultant for MS Research Australia. Tomas Kalincik has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Tomas Kalincik has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Tomas Kalincik has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi Genzyme. Tomas Kalincik has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Tomas Kalincik has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Tomas Kalincik has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Janssen. Tomas Kalincik has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bristol Myers Squibb. Tomas Kalincik has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for WebMD Global. Tomas Kalincik has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Novartis. Tomas Kalincik has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Biogen. Tomas Kalincik has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Sanofi Genzyme. Tomas Kalincik has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Teva. Tomas Kalincik has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for BioCSL. Tomas Kalincik has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Merck. Tomas Kalincik has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Eisai. The institution of Tomas Kalincik has received research support from Biogen. The institution of Tomas Kalincik has received research support from Novartis. The institution of Tomas Kalincik has received research support from Genzyme. The institution of Tomas Kalincik has received research support from Roche. The institution of Tomas Kalincik has received research support from Celgene. The institution of Tomas Kalincik has received research support from Merck. The institution of Tomas Kalincik has received research support from MSBase Foundation. The institution of Tomas Kalincik has received research support from ARSEP and EDMUS Foundations. The institution of Tomas Kalincik has received research support from MS Research Australia. The institution of Tomas Kalincik has received research support from National Health and Medical Research Council. The institution of Tomas Kalincik has received research support from Australian Research Council. The institution of Tomas Kalincik has received research support from MS Society. The institution of Tomas Kalincik has received research support from Trish Foundation. Tomas Kalincik has a non-compensated relationship as a scientific leadership group chair with MSBase Foundation that is relevant to AAN interests or activities.
Sifat Sharmin, PhD (University of Melbourne)	Dr. Sharmin has nothing to disclose.
	No disclosure on file
	No disclosure on file
Emmanuelle Leray (EHESP)	No disclosure on file
	No disclosure on file
Eva Havrdova, MD (Neurologicka Klinika 1 LF UK)	Dr. Havrdova has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. Dr. Havrdova has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sanofi. Dr. Havrdova has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. Havrdova has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Havrdova has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Havrdova has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Dr. Havrdova has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi.
Raed Alroughani, MD, FAAN	Dr. Alroughani has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen, AstraZeneca, Novartis, Merck, Roche, Sanofi. Dr. Alroughani has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for AstraZeneca, Biogen, Novartis, Merck, Roche, Sanofi.
Guillermo Izquierdo Ayuso, MD (Servicio De Neurologia)	Dr. Izquierdo Ayuso has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bayer, Biogen Idec, Novartis, Sanofi, Merck Serono, Roche, Actelion and Celgene. Dr. Izquierdo Ayuso has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genzyme, Novartis, Sanofi Aventis, Alexion.
Serkan Ozakbas, MD (Department of Neurology Izmir University of Economics Medical Point Hospital)	Dr. Ozakbas has nothing to disclose.
Francesco Patti, MD	Dr. Patti has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alexion. The institution of Dr. Patti has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Almirall. Dr. Patti has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bristol Meyers. Dr. Patti has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Johnson and Johnson. The institution of Dr. Patti has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Merck. The institution of Dr. Patti has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. The institution of Dr. Patti has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Roche. The institution of Dr. Patti has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Sanofi. Dr. Patti has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion, Almirall, Bayer, Biogen, Bristol Meyers and Squibb Merck, Roche, Sanofi, TEVA. Dr. Patti has received personal compensation in the range of $500-$4,999 for serving as an officer or member of the Board of Directors for University of Catania and AISM/FISM, Fondazione Italiana Sclerosi Multipla. Dr. Patti has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Frontiers in Neurology.
Marco Onofrj, MD	Dr. Onofrj has nothing to disclose.
Alessandra Lugaresi, MD (Istituto delle Scienze Neurologiche di Bologna)	Dr. Lugaresi has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Merck Serono. Dr. Lugaresi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis Pharma. Dr. Lugaresi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi-Genzyme. Dr. Lugaresi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Lugaresi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Teva. Dr. Lugaresi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. Lugaresi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Mylan. Dr. Lugaresi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bristol Myers Sqibb. Dr. Lugaresi has a non-compensated relationship as a Speaker at meetings, participant in trials with Fondazione Italiana Sclerosi Multipla that is relevant to AAN interests or activities.
Murat Terzi, PhD (19 Mayis Universitesi)	Dr. Terzi has nothing to disclose.
Pierre Grammond, MD (Hotel-Dieu De Levis Hospital)	Dr. Grammond has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Grammond has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Grammond has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Grammond has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Pendopharm. Dr. Grammond has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Grammond has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Grammond has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Serono. The institution of Dr. Grammond has received research support from Roche.
Francois Grand-Maison, MD (Francois Grand'Maison MD INC)	Dr. Grand-Maison has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Grand-Maison has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sanofi. Dr. Grand-Maison has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Serono. Dr. Grand-Maison has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. Grand-Maison has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis .
Bassem I. Yamout, MD, FAAN (Harley Street Medical Center)	Dr. Yamout has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Dr. Yamout has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Yamout has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Yamout has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Yamout has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi.
Alexandre Prat, MD (CHUM Hopital Norte Dame/ Dept of Neurology)	The institution of Dr. Prat has received research support from CIHR and MSSC.
J M. Girard, MD	Dr. Girard has nothing to disclose.
Pierre Duquette, MD	The institution of Dr. Duquette has received research support from Biogen and Genzyme.
Cavit Boz, MD	Dr. Boz has nothing to disclose.
Maria Trojano (Policlinico - Bari)	Maria Trojano has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Maria Trojano has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Maria Trojano has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Maria Trojano has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Maria Trojano has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi_Genzyme. Maria Trojano has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Janssen. Maria Trojano has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sandoz. Maria Trojano has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen. Maria Trojano has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Merck. Maria Trojano has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. Maria Trojano has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi-Genzyme. Maria Trojano has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Maria Trojano has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Janssen.
Pamela A. McCombe, MD (Dr PA McCombe Medical Pty Ltd)	Dr. McCombe has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. McCombe has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. McCombe has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genzyme. The institution of Dr. McCombe has received research support from Motor Neurone Disease Resaerch Institute of Australia.
Mark Slee, MBBS, PhD, FRACP (Flinders Medical Centre, Bedford Park)	Dr. Slee has nothing to disclose.
Jeannette Lechner-Scott, MD, PhD, FRACP (HNEAH)	The institution of Prof. Lechner-Scott has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. The institution of Prof. Lechner-Scott has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. The institution of Prof. Lechner-Scott has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Janssen. The institution of Prof. Lechner-Scott has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. The institution of Prof. Lechner-Scott has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for elsevier. The institution of Prof. Lechner-Scott has received research support from Merck. The institution of Prof. Lechner-Scott has received research support from Biogen.
Recai Turkoglu	Recai Turkoglu has nothing to disclose.
Patrizia Sola (Nuovo Ospedale Civile S. Agostino-Estense)	Patrizia Sola has nothing to disclose.
Diana Ferraro, MD, PhD (University of Modena and Reggio Emilia)	Dr. Ferraro has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Genzyme. Dr. Ferraro has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Ferraro has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Dr. Ferraro has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Ferraro has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for TEVA. Dr. Ferraro has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Binding Site. Dr. Ferraro has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Merck.
Franco Granella (Zeneca-UK)	Franco Granella has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Franco Granella has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Franco Granella has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck Serono.
Julie Prevost, MD (Neurologie des Laurentides)	No disclosure on file
Davide Maimone, MD, PhD (Neurology Unit, Ospedale Garibaldi - Catania)	Dr. Maimone has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Dr. Maimone has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Maimone has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Maimone has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi-Genzyme. Dr. Maimone has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Almirall. Dr. Maimone has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Teva.
Olga Skibina (Neurosciences, Box Hill Hospital)	Olga Skibina has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck.
Katherine Buzzard, MBBS, PhD, FRACP (Eastern Health, Dept Neuroscience)	Dr. Buzzard has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Dr. Buzzard has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Biogen. Dr. Buzzard has received personal compensation in the range of $5,000-$9,999 for serving as a support to attend educational conference with Roche.
Anneke Van Der Walt, MD (Alfred Health)	Dr. Van Der Walt has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Dr. Van Der Walt has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Van Der Walt has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Van Der Walt has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Dr. Van Der Walt has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen. The institution of Dr. Van Der Walt has received research support from NHMRC Australia. The institution of Dr. Van Der Walt has received research support from MSRA. The institution of Dr. Van Der Walt has received research support from Roche.
Bart Van Wijmeersch, MD, PhD (Rehabilitation & MS-Centre Overpelt)	Prof. Van Wijmeersch has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Prof. Van Wijmeersch has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Prof. Van Wijmeersch has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Prof. Van Wijmeersch has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Prof. Van Wijmeersch has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Celgene/Bristol Myers Group. Prof. Van Wijmeersch has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Prof. Van Wijmeersch has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Janssen Pharmaceutics. Prof. Van Wijmeersch has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen. Prof. Van Wijmeersch has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Merck. Prof. Van Wijmeersch has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi. Prof. Van Wijmeersch has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Prof. Van Wijmeersch has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. The institution of Prof. Van Wijmeersch has received research support from Merck. The institution of Prof. Van Wijmeersch has received research support from Roche.
Tunde Csepany, MD (University of Debrecen)	Dr. Csepany has nothing to disclose.
Daniele Litterio A. Spitaleri (A.O. "S. Giuseppe Moscati")	Daniele Litterio A. Spitaleri has received research support from Novartis.
Ostoja (Steve) Vucic, MBBS, FRACP (Concord Hosoital)	Prof. Vucic has a non-compensated relationship as a Member-Advisory Board with Biogen Idec Australia that is relevant to AAN interests or activities. Prof. Vucic has a non-compensated relationship as a Honorarium with Merkc Serono Ausralia that is relevant to AAN interests or activities.
	No disclosure on file
Marc Debouverie, MD (Hospital Central)	Dr. Debouverie has nothing to disclose.
Gilles Edan	Gilles Edan has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Celgene. Gilles Edan has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Gilles Edan has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Biogen. Gilles Edan has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Merck.
Jonathan Ciron, MD (CHU Toulouse)	Jonathan Ciron, MD has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Jonathan Ciron, MD has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Jonathan Ciron, MD has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Jonathan Ciron, MD has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for BMS - Celgene. Jonathan Ciron, MD has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion.
Aurelie Ruet (Hopital Pellegrin)	The institution of Aurelie Ruet has received research support from BIOGEN. The institution of Aurelie Ruet has received research support from ROCHE. The institution of Aurelie Ruet has received research support from SANOFI GENZYME. The institution of Aurelie Ruet has received research support from BMS. Aurelie Ruet has received personal compensation in the range of $0-$499 for serving as a Board member with Horizon therapeutic. Aurelie Ruet has received personal compensation in the range of $0-$499 for serving as a Board member with Alexion. Aurelie Ruet has received personal compensation in the range of $0-$499 for serving as a Speaker meeting with BIOGEN. Aurelie Ruet has received personal compensation in the range of $500-$4,999 for serving as a Speaker meeting with MERCK. Aurelie Ruet has received personal compensation in the range of $0-$499 for serving as a Speaker meeting with Sanofi Genzyme.
	No disclosure on file
	No disclosure on file
Helene Zephir (Hospital Roger Salengro)	Helene Zephir has received personal compensation in the range of $0-$499 for serving as a Consultant for BIogen Idec. Helene Zephir has received personal compensation in the range of $0-$499 for serving as a Consultant for novartis. Helene Zephir has received personal compensation in the range of $0-$499 for serving as a Consultant for BMS. Helene Zephir has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alexion.
Pierre Labauge, MD	Dr. Labauge has nothing to disclose.
Gilles Defer, MD (Hopital Cote De Nacre)	Dr. Defer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. Defer has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen . Dr. Defer has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis . Dr. Defer has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche.
	No disclosure on file
Thibault Moreau	Thibault Moreau has nothing to disclose.
	No disclosure on file
Pierre Clavelou, MD, PhD (Hopital Gabriel Montpied)	Dr. Clavelou has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Clavelou has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Janssen. Dr. Clavelou has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck.
Jean Pelletier, MD, PhD (Dpt of Neurology, CHU Timone)	Dr. Pelletier has nothing to disclose.
Bruno Stankoff, MD, PhD (Hopital De La Pitie Salpetriere)	The institution of Bruno Stankoff, MD, PhD has received research support from Roche, Sanofi, Serono . The institution of Bruno Stankoff, MD, PhD has received research support from Novartis.
Olivier F. Gout, MD (Hôpital Fondation A de Rothschild)	Dr. Gout has nothing to disclose.
Eric Thouvenot, MD, PhD (CHU De Nimes - Hopital Caremeau)	Dr. Thouvenot has received personal compensation in the range of $0-$499 for serving as a Consultant for Biogen. Dr. Thouvenot has received personal compensation in the range of $0-$499 for serving as a Consultant for Merck. Dr. Thouvenot has received personal compensation in the range of $0-$499 for serving as a Consultant for Teva. Dr. Thouvenot has received personal compensation in the range of $0-$499 for serving as a Consultant for Novartis. Dr. Thouvenot has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Thouvenot has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. The institution of Dr. Thouvenot has received research support from Biogen. The institution of Dr. Thouvenot has received research support from Novartis. The institution of Dr. Thouvenot has received research support from Roche.
Olivier Heinzlef, MD (Hospital De Poissy)	Dr. Heinzlef has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. Dr. Heinzlef has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Heinzlef has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Edimark.
Abdullatif Al Khedr (CHRU Amiens Nord)	No disclosure on file
Bertrand Bourre	Bertrand Bourre has nothing to disclose.
Olivier Casez, MD (CHU De Grenoble)	Dr. Casez has nothing to disclose.
Philippe Cabre	No disclosure on file
Alexis Montcuquet	Alexis Montcuquet has nothing to disclose.
	No disclosure on file
Jean-Phillippe Camdessanche	Jean-Phillippe Camdessanche has nothing to disclose.
Aude Maurousset	Aude Maurousset has received personal compensation in the range of $0-$499 for serving as a Consultant for novartis. Aude Maurousset has received personal compensation in the range of $0-$499 for serving as a Consultant for merck. Aude Maurousset has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for roche.
Ivania Patry, MD (Hopital Pellegrin)	No disclosure on file
Karolina Hankiewicz Kryska	No disclosure on file
Corinne Pottier	Corinne Pottier has nothing to disclose.
	No disclosure on file
	No disclosure on file
	No disclosure on file
David Laplaud	No disclosure on file
Nils Koch-Henriksen, MD (Dept of Neurology, Aalborg Hospital)	Dr. Koch-Henriksen has nothing to disclose.
Finn Sellebjerg, MD (Copenhagen University Hospital Rigshospitalet)	Dr. Sellebjerg has received personal compensation for serving as an employee of Danish Multiple Sclerosis Society. Dr. Sellebjerg has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. Dr. Sellebjerg has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Sellebjerg has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Sellebjerg has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Sellebjerg has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi Genzyme. Dr. Sellebjerg has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen. Dr. Sellebjerg has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. Dr. Sellebjerg has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Dr. Sellebjerg has received personal compensation in the range of $500-$4,999 for serving as an officer or member of the Board of Directors for Gangsted Foundation. Dr. Sellebjerg has received personal compensation in the range of $500-$4,999 for serving as an officer or member of the Board of Directors for Warwara Larsen Foundation. The institution of Dr. Sellebjerg has received research support from Biogen. The institution of Dr. Sellebjerg has received research support from Merck. The institution of Dr. Sellebjerg has received research support from Novartis. The institution of Dr. Sellebjerg has received research support from Sanofi Genzyme. Dr. Sellebjerg has received publishing royalties from a publication relating to health care.
Per Soelberg Sorensen	No disclosure on file
Claudia Christina H. Kristensen, MD (Aalborg University Hospital)	No disclosure on file
Peter Vestergaard Rasmussen (Århus Sygehus)	No disclosure on file
Michael Jensen	No disclosure on file
Jette Lautrup Frederiksen Battisti, MD (Glostrup University Hospital)	No disclosure on file
Stephan Bramow, MD (Danish MS Research Center)	Dr. Bramow has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen.
Henrik Kahr K. Mathiesen, MD (Danish MS Research Center, Rigshospitalet)	No disclosure on file
	No disclosure on file
Melinda Magyari, MD	Dr. Magyari has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Magyari has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. Dr. Magyari has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Magyari has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Dr. Magyari has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Magyari has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Dr. Magyari has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Magyari has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Bristol Myers Squibb. The institution of Dr. Magyari has received research support from The Danish MS Society. The institution of Dr. Magyari has received research support from Biogen. The institution of Dr. Magyari has received research support from Novartis. The institution of Dr. Magyari has received research support from Roche. The institution of Dr. Magyari has received research support from Merck. The institution of Dr. Magyari has received research support from Sanofi.
Sandra Vukusic, MD (Hopital Neurologique Pierre Wertheimer)	The institution of Dr. Vukusic has received research support from Biogen. The institution of Dr. Vukusic has received research support from Janssen. The institution of Dr. Vukusic has received research support from Merck. The institution of Dr. Vukusic has received research support from Novartis. The institution of Dr. Vukusic has received research support from Roche.
Helmut Butzkueven, MD, MBBS	Dr. Butzkueven has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Oxford Health Policy Forum. The institution of Dr. Butzkueven has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biogen. The institution of Dr. Butzkueven has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Merck. The institution of Dr. Butzkueven has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis. The institution of Dr. Butzkueven has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Roche. Dr. Butzkueven has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for MSBase . The institution of Dr. Butzkueven has received research support from NHMRC. The institution of Dr. Butzkueven has received research support from Biogen. The institution of Dr. Butzkueven has received research support from Roche. The institution of Dr. Butzkueven has received research support from Novartis.

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