Figure 4.

Pathways of disease-modifying treatments (DMTs) before final switch to alemtuzumab. The figure displays the pathways of DMTs before the final switch to alemtuzumab (before or at the inclusion visit of the study). The various MS medications are represented by different colors (alemtuzumab blue, fingolimod light orange, interferon-beta light green, glatiramer acetate green); the height of the stacked vertical bar represents the number of patients treated with the respective MS medication. The width of the lines (ribbons) that connect the individual stacked columns visualizes the number of patients who are transferred to the same (same color) or another medication (different color). It is clearly visible by the wide ribbons that “typical” pathways in this study were from interferon-beta to natalizumab, from interferon-beta to fingolimod, and from natalizumab to fingolimod. Patients were excluded if the exact treatment order could not be determined (29 cases unknown, 127 no pretreatment, 104 last pretreatments not identifiable), leaving 623 patients in the chart. Chronological treatment sequence order starts on the left and ends with alemtuzumab on the right. See also editable Figure 5.