PMID- 36055929
OWN - NLM
STAT- MEDLINE
DCOM- 20230124
LR  - 20240203
IS  - 1544-3450 (Electronic)
IS  - 1086-5802 (Linking)
VI  - 63
IP  - 1
DP  - 2023 Jan-Feb
TI  - Comparative efficacy and safety of disease-modifying therapies in patients with 
      relapsing multiple sclerosis: A systematic review and network meta-analysis.
PG  - 8-22.e23
LID - S1544-3191(22)00241-2 [pii]
LID - 10.1016/j.japh.2022.07.009 [doi]
AB  - BACKGROUND: Currently, 19 disease-modifying therapies (DMTs) have been approved 
      for the treatment of patients with relapsing forms of multiple sclerosis (RMS). 
      OBJECTIVE: The objective of this study was to conduct a systematic review and 
      network meta-analysis to evaluate the efficacy and safety of DMTs in adults with 
      RMS. METHODS: We searched PubMed, Embase, the Cochrane Central Register of 
      Controlled Trials, ClinicalTrials.gov, the Food and Drug Administration, and 
      European Medicines Agency websites for randomized controlled trials (RCTs) (from 
      inception to July 2021). Eligible RCTs evaluated approved treatments for RMS as 
      monotherapy and reported at least one of the primary outcome measures of 
      interest. The primary outcome was efficacy (annualized relapse rate and 12-week 
      confirmed disability progression) and safety (serious adverse events [AEs] and 
      discontinuation due to AEs). We assessed the risk of bias (RoB) of included 
      studies using the Cochrane RoB tool version 2.0 
      (https://www.bmj.com/content/343/bmj.d5928) for RCTs. Surface under the 
      cumulative ranking (SUCRA) was used to rank therapies and to assess quality of 
      general evidence, respectively. The Grading of Recommendations Assessment, 
      Development and Evaluation framework was used to rank therapies and to assess 
      quality of general evidence. RESULTS: A total of 43 records represent 45 RCTs 
      selected for network meta-analysis. In total, 30,720 participants (median of 732; 
      interquartile range: 248-931) were included, of which 67% were female. By SUCRA 
      analysis, alemtuzumab (94.3%) presented the highest probability of being the best 
      alternative for annualized relapse rate, whereas ofatumumab (93.5%) presented the 
      highest probability of being the best alternative for 12-week confirmed 
      disability progression. Interferon beta-1b subcutaneous (87.0%) presented the 
      highest probability of the best safety among all DMTs for serious AEs, whereas 
      alemtuzumab (92.4%) presented the highest probability of the best safety among 
      all DMTs for discontinuation due to AEs. CONCLUSION: Network meta-analysis shows 
      that alemtuzumab and ofatumumab present the highest efficacy among DMTs. Because 
      there is little difference between these probabilities for many treatments, 
      health professionals should use clinical shared decision making when formulating 
      treatment plans with patients.
CI  - Copyright (c) 2022 American Pharmacists Association(R). Published by Elsevier Inc. 
      All rights reserved.
FAU - Chen, Chaoyang
AU  - Chen C
FAU - Zhang, Enyao
AU  - Zhang E
FAU - Zhu, Chunsu
AU  - Zhu C
FAU - Wei, Ran
AU  - Wei R
FAU - Ma, Lingyun
AU  - Ma L
FAU - Dong, Xiu
AU  - Dong X
FAU - Li, Ruoming
AU  - Li R
FAU - Sun, Feng
AU  - Sun F
FAU - Zhou, Ying
AU  - Zhou Y
FAU - Cui, Yimin
AU  - Cui Y
FAU - Liu, Zhenming
AU  - Liu Z
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
DEP - 20220801
PL  - United States
TA  - J Am Pharm Assoc (2003)
JT  - Journal of the American Pharmacists Association : JAPhA
JID - 101176252
RN  - 3A189DH42V (Alemtuzumab)
SB  - IM
EIN - J Am Pharm Assoc (2003). 2024 Jan-Feb;64(1):e3. PMID: 38309789
MH  - United States
MH  - Adult
MH  - Female
MH  - Humans
MH  - Male
MH  - Alemtuzumab
MH  - Network Meta-Analysis
MH  - *Multiple Sclerosis
MH  - Chronic Disease
MH  - Recurrence
EDAT- 2022/09/03 06:00
MHDA- 2023/01/25 06:00
CRDT- 2022/09/02 22:07
PHST- 2022/05/07 00:00 [received]
PHST- 2022/07/20 00:00 [revised]
PHST- 2022/07/21 00:00 [accepted]
PHST- 2022/09/03 06:00 [pubmed]
PHST- 2023/01/25 06:00 [medline]
PHST- 2022/09/02 22:07 [entrez]
AID - S1544-3191(22)00241-2 [pii]
AID - 10.1016/j.japh.2022.07.009 [doi]
PST - ppublish
SO  - J Am Pharm Assoc (2003). 2023 Jan-Feb;63(1):8-22.e23. doi: 
      10.1016/j.japh.2022.07.009. Epub 2022 Aug 1.