Disease-Modifying Therapies for Relapsing-Remitting Multiple Sclerosis: A Network Meta-Analysis.

CNS Drugs
Rosa C LucchettaA Wiens

Abstract

A broad range of disease-modifying therapies (DMTs) for relapsing-remitting multiple sclerosis (RRMS) is available. However, the efficacy and safety of traditional DMTs compared with the recently developed DMTs remain unclear. Therefore, we have synthesised available evidence of clinical outcomes for DMTs in adults with RRMS. PubMed, Scopus and a manual search were performed. Bayesian network meta-analyses of randomised clinical trials assessing DMTs as monotherapies were conducted. SUCRA and GRADE were used to rank therapies and to assess quality of general evidence, respectively. Thirty-three studies were included in the meta-analyses. The most effective therapies for the outcome of annualised relapse rate were alemtuzumab (96% probability), natalizumab (96%) and ocrelizumab (85%), compared with all other therapies (hazard ratio versus placebo, 0.31, 0.31 and 0.37, respectively; p < 0.05 for all comparisons) (high-quality evidence). However, no significant differences among these three therapies were found. Discontinuation due to adverse events revealed similarity across all therapies, except for alemtuzumab, which showed less discontinuation when compared with interferon-1a intramuscular (relative risk 0.37; p < 0.05). High-...Continue Reading

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Citations

May 17, 2019·Expert Review of Neurotherapeutics·Laura De GiglioCarlo Pozzilli
Jun 17, 2020·Expert Opinion on Pharmacotherapy·Cristina Valencia-Sanchez, Jonathan L Carter
Feb 19, 2020·The Journal of Neuroscience Nursing : Journal of the American Association of Neuroscience Nurses·Trudy L CampbellCharles Minor
Aug 18, 2020·Neurology. Neuroimmunology and Neuroinflammation·Alessio SignoriMaria Pia Sormani
Oct 23, 2020·Journal of Comparative Effectiveness Research·Imtiaz A SamjooNicholas Adlard
Feb 17, 2021·Multiple Sclerosis and Related Disorders·Mohaddeseh H GoudarziSamantha A Hollingworth
Feb 24, 2021·Journal of Comparative Effectiveness Research·Imtiaz A SamjooNicholas Adlard
Oct 6, 2021·Journal of Comparative Effectiveness Research·Imtiaz A SamjooNicholas Adlard
Sep 8, 2021·Neuropathology and Applied Neurobiology·Francesca De VitoGeorgia Mandolesi

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