biostudies-literatureUnknown22(1)Lefort M<h4>Background</h4>Natalizumab and fingolimod are used as high-efficacy treatments in relapsing-remitting multiple sclerosis. Several observational studies comparing these two drugs have shown variable results, using different methods to control treatment indication bias and manage censoring. The objective of this empirical study was to elucidate the impact of methods of causal inference on the results of comparative effectiveness studies.<h4>Methods</h4>Data from three observational multiple sclerosis registries (MSBase, the Danish MS Registry and French OFSEP registry) were combined. Four clinical outcomes were studied. Propensity scores were used to match or weigh the compared groups, allowing for estimating average treatment effect for treated or average treatment effect for the entireBMC medical research methodology155https://www.ebi.ac.uk/biostudies/studies/S-EPMC9150358biostudies-literatureImpact of methodological choices in comparative effectiveness studies: application in natalizumab versus fingolimod comparison among patients with multiple sclerosis.PMC9150358Labauge PAlroughani RHeinzlef OSlee MKalincik TJensen MBDebouverie MMoreau TKarabudak RMagyari MSola PCasez OVucic SYamout BShaygannejad VAndersen JBMaimone DKoch-Henriksen NVukusic SHankiewicz KMaurousset ALugaresi AVan Wijmeersch BZephir HCiron JMcCombe PThouvenot ELefort MHavrdova EKOzakbas SSoerensen PSCabre PMaillart EBuzzard KFerraro DBerger ESchreiber KIPelletier JCamdessanche JPClavelou PMaubeuge NDefer GDimitri-Boulos DPottier CDuquette PEdan GGrammond PStankoff BPrat AMontcuquet ATurkoglu RBoz CHorakova DCsepany TTrojano MPatti FCasey RDe Seze JMathiesen HKFrederiksen JLRasmussen PVLechner-Scott JBourre BOnofrj MSpitaleri DIzquierdo GHilt Christensen CCNifle CEichau SGirard MGrand'Maison FSkibina OSellebjerg FLebrun-Frenay CWahab APrevost JGout OGranella FVan der Walt AButzkueven HBen Nasr HLeray EAl-Khedr ATerzi MBramow SLaplaud DARuet ASharmin SfalseImpact of methodological choices in comparative effectiveness studies: application in natalizumab versus fingolimod comparison among patients with multiple sclerosis.<h4>Background</h4>Natalizumab and fingolimod are used as high-efficacy treatments in relapsing-remitting multiple sclerosis. Several observational studies comparing these two drugs have shown variable results, using different methods to control treatment indication bias and manage censoring. The objective of this empirical study was to elucidate the impact of methods of causal inference on the results of comparative effectiveness studies.<h4>Methods</h4>Data from three observational multiple sclerosis registries (MSBase, the Danish MS Registry and French OFSEP registry) were combined. Four clinical outcomes were studied. Propensity scores were used to match or weigh the compared groups, allowing for estimating average treatment effect for treated or average treatment effect for the entire2022-01-01T00:00:00Z2022 May2025-04-04T09:41:35.839Z2025-04-04T09:41:35.839ZS-EPMC91503583563742610.1186/s12874-022-01623-8