Subgroups of multiple sclerosis patients with larger treatment benefits: a meta-analysis of randomized trials

European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies
Alessio SignoriMaria Pia Sormani

Abstract

No subgroups of patients with higher treatment effects have been clearly detected in multiple sclerosis (MS). The aim of the present work was to evaluate whether there are subgroups of relapsing-remitting MS (RRMS) patients who are more responsive to treatments. All published randomized clinical trials in RRMS reporting a subgroup analysis of treatment effect were collected. Two main outcomes, the annualized relapse rate (ARR) and the disability progression, were studied. The treatment effect in each subgroup was reported as a relative effect (RE), defined as the treatment effect in the subgroup relative to the overall effect. A meta-analysis was run to compare the RE between subgroups. Six trials (6693 RRMS patients) were included. Treatment effects on ARR were significantly higher in younger than in older subjects (RE = 0.83 vs. RE = 1.30, P < 0.001), in patients with than those without gadolinium activity (RE = 0.86 vs. RE = 1.15, P = 0.005) and in patients with lower than in those with higher Expanded Disability Status Scale (RE = 0.96 vs. RE = 1.23, P = 0.02), and on disability progression in younger than in older subjects (RE = 0.82 vs. RE = 1.28, P = 0.017). This study formally shows that in RRMS higher treatment effects...Continue Reading

Associated Clinical Trials

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Citations

Sep 20, 2016·Multiple Sclerosis and Related Disorders·Gavin GiovannoniTimothy Vollmer
Nov 25, 2016·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·A H V Schapira
Feb 7, 2017·Expert Review of Clinical Immunology·Tjalf Ziemssen, Katja Thomas
Feb 13, 2016·Multiple Sclerosis : Clinical and Laboratory Research·A ScalfariP A Muraro
Jul 5, 2017·Multiple Sclerosis : Clinical and Laboratory Research·John R Corboy
Aug 3, 2018·Multiple Sclerosis : Clinical and Laboratory Research·Valentina TomassiniCarlo Pozzilli
Aug 12, 2017·Nature Reviews. Neurology·Andrew J Solomon, John R Corboy
May 31, 2019·Multiple Sclerosis : Clinical and Laboratory Research·Fabio PellegriniMaria Pia Sormani
Jul 30, 2019·Multiple Sclerosis : Clinical and Laboratory Research·Natalie A SchwehrUNKNOWN BeAMS Study Group
Dec 28, 2018·Neurology·Claudio GasperiniUNKNOWN the MAGNIMS Study Group
Jan 10, 2020·Drugs & Aging·Natalie A SchwehrUNKNOWN BeAMS Study group
Mar 10, 2017·Multiple Sclerosis : Clinical and Laboratory Research·Maria Pia Sormani
Mar 1, 2019·Multiple Sclerosis Journal - Experimental, Translational and Clinical·Sarah L MindenLisa I Iezzoni
Oct 27, 2020·Multiple Sclerosis : Clinical and Laboratory Research·Luca ProsperiniClaudio Gasperini
Jan 22, 2021·Journal of Neurology·Malin BoremalmJonatan Salzer
Dec 5, 2020·Multiple Sclerosis and Related Disorders·Le H HuaKathryn C Fitzgerald
Jan 22, 2021·Multiple Sclerosis and Related Disorders·Ann D BassUNKNOWN CARE-MS I, CARE-MS II, CAMMS03409, and TOPAZ investigators
Nov 4, 2020·Journal of Neurology·Emma C TallantyreWendy Ingram
Feb 13, 2021·Multiple Sclerosis and Related Disorders·Per Soelberg SorensenMelinda Magyari
Feb 9, 2021·Therapeutic Advances in Neurological Disorders·Yinan ZhangOlaf Stϋve
Feb 18, 2021·Expert Review of Neurotherapeutics·Dejan JakimovskiBianca Weinstock-Guttman
Apr 20, 2021·Therapeutic Advances in Neurological Disorders·Yinan ZhangOlaf Stuve
Jun 18, 2021·Lancet Neurology·Mike P WattjesUNKNOWN North American Imaging in Multiple Sclerosis Cooperative MRI guidelines working group

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