PMID- 33878488
OWN - NLM
STAT- MEDLINE
DCOM- 20210518
LR  - 20210518
IS  - 1873-0183 (Electronic)
IS  - 1568-9972 (Linking)
VI  - 20
IP  - 6
DP  - 2021 Jun
TI  - Disease modifying therapies in relapsing-remitting multiple sclerosis: A 
      systematic review and network meta-analysis.
PG  - 102826
LID - S1568-9972(21)00098-7 [pii]
LID - 10.1016/j.autrev.2021.102826 [doi]
AB  - OBJECTIVE: To compare the efficacy and compliance of up-to-date disease modifying 
      therapies (DMTs) in patients with remitting-relapsing MS (RRMS). METHODS: We 
      searched PubMed, EMBASE and Cochrane Library for eligible studies. Annualized 
      relapse rate, discontinuation due to adverse events (AEs) were assessed as 
      primary outcomes. Sensitivity analysis and inconsistency detection were performed 
      to evaluated whether exclusion of high-risk studies affected the validity. Risk 
      of bias was assessed using Cochrane's Risk-of-Bias Tool 2. Surface under the 
      cumulative ranking curve (SUCRA) was used to estimate the rankings among 
      different DMTs. RESULTS: 21 studies were included for main report. Seven studies 
      were evaluated as "high risk" and were therefore excluded. Exclusion of high-risk 
      studies did not affect the validity of evidence. The risk of relapses for most 
      DMTs except Betaseron 50 mug was significantly lower comparing to placebo. 
      Incompliance in patients treated with DMTs was not significantly increased 
      comparing to placebo. Dimethyl fumarate and ocrelizumab had superiority in 
      improving MRI outcomes. Ocrelizumab and ofatumumab had the largest reduction of 
      risk in disability progression at 3 months. Referring to SUCRA, ofatumumab, 
      alemtuzumab and natalizumab showed the best efficacy and compliance. CONCLUSION: 
      The present study demonstrated the hierarchy of DMTs treating RRMS. Ofatumumab, 
      alemtuzumab and natalizumab have superiority with respect to effectiveness and 
      compliance. More studies are required to explore the long-term effect of DMTs. 
      Our findings could provide helpful information and contribute to clinical 
      treatment decision-making.
CI  - Copyright (c) 2021 Elsevier B.V. All rights reserved.
FAU - Liu, Zhuoyi
AU  - Liu Z
AD  - Department of Anesthesiology, Xiangya Hospital, Central South University, 
      Changsha, Hunan, China.
FAU - Liao, Qiao
AU  - Liao Q
AD  - Department of Neurology, Xiangya Hospital, Central South University, Changsha, 
      Hunan, China.
FAU - Wen, Haicheng
AU  - Wen H
AD  - Xiangya Hospital, Central South University, Changsha, Hunan, China.
FAU - Zhang, Yihao
AU  - Zhang Y
AD  - Department of General Surgery, Nanfang Hospital, Southern Medical University, 
      Guangzhou, Guangdong, China. Electronic address: tomas4482@hotmail.com.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
DEP - 20210418
PL  - Netherlands
TA  - Autoimmun Rev
JT  - Autoimmunity reviews
JID - 101128967
RN  - 0 (Immunologic Factors)
RN  - 0 (Immunosuppressive Agents)
RN  - 0 (Natalizumab)
SB  - IM
MH  - Humans
MH  - Immunologic Factors
MH  - Immunosuppressive Agents/therapeutic use
MH  - *Multiple Sclerosis
MH  - *Multiple Sclerosis, Relapsing-Remitting/drug therapy
MH  - Natalizumab
MH  - Network Meta-Analysis
OTO - NOTNLM
OT  - Disease modifying therapy
OT  - Network meta-analysis
OT  - Relapsing-remitting multiple sclerosis
EDAT- 2021/04/21 06:00
MHDA- 2021/05/19 06:00
CRDT- 2021/04/20 20:11
PHST- 2021/02/10 00:00 [received]
PHST- 2021/02/17 00:00 [accepted]
PHST- 2021/04/21 06:00 [pubmed]
PHST- 2021/05/19 06:00 [medline]
PHST- 2021/04/20 20:11 [entrez]
AID - S1568-9972(21)00098-7 [pii]
AID - 10.1016/j.autrev.2021.102826 [doi]
PST - ppublish
SO  - Autoimmun Rev. 2021 Jun;20(6):102826. doi: 10.1016/j.autrev.2021.102826. Epub 
      2021 Apr 18.