BACKGROUND: In recent years the impact of disease-modifying drugs on long-term progression in multiple sclerosis (MS) was assessed both in observational studies and in extension of randomized controlled trial (RCT). Aim of this work was to quantitatively summarize by a meta-analysis the long-term impact of immunomodulatory drugs (Interferon-Beta (IFN-β) or Glatiramer Acetate (GA)) in relapsing-remitting (RR) MS patients. METHODS: We collected all published observational studies reporting the long-term efficacy of IFN-β or GA in RRMS patients. The primary outcome was the treatment effect on progression to a sustained EDSS score of 6 or to the Secondary Progressive (SP) phase. A non-parametric approach was adopted to test the overall treatment effect significance, while a random effect model was used to obtain a pooled quantitative estimate of the treatment benefit, in terms of hazard-ratios (HR) or Relative Risks, with their 95% confidence interval (CI). RESULTS: Fourteen studies, on a total of 13,238 RRMS patients, were included in the meta-analysis. All studies but two reported a consistent effect of immunomodulatory treatment on long-term disease progression; the pooled effect on progression to EDSS 6 or SP was significant (p<0.01) when tested by the non-parametric test. The quantitative estimate of the treatment effect in reducing progression to EDSS 6 in the subset of studies reporting this outcome was HRpooled=0.49 (95% CI: 0.34-0.69), p<0.001. CONCLUSIONS: Treatment with immunomodulators seems to reduce long-term probability of disability progression. Additional well-designed observational studies could help to confirm these findings.
BACKGROUND: In recent years the impact of disease-modifying drugs on long-term progression in multiple sclerosis (MS) was assessed both in observational studies and in extension of randomized controlled trial (RCT). Aim of this work was to quantitatively summarize by a meta-analysis the long-term impact of immunomodulatory drugs (Interferon-Beta (IFN-β) or Glatiramer Acetate (GA)) in relapsing-remitting (RR) MS patients. METHODS: We collected all published observational studies reporting the long-term efficacy of IFN-β or GA in RRMS patients. The primary outcome was the treatment effect on progression to a sustained EDSS score of 6 or to the Secondary Progressive (SP) phase. A non-parametric approach was adopted to test the overall treatment effect significance, while a random effect model was used to obtain a pooled quantitative estimate of the treatment benefit, in terms of hazard-ratios (HR) or Relative Risks, with their 95% confidence interval (CI). RESULTS: Fourteen studies, on a total of 13,238 RRMS patients, were included in the meta-analysis. All studies but two reported a consistent effect of immunomodulatory treatment on long-term disease progression; the pooled effect on progression to EDSS 6 or SP was significant (p<0.01) when tested by the non-parametric test. The quantitative estimate of the treatment effect in reducing progression to EDSS 6 in the subset of studies reporting this outcome was HRpooled=0.49 (95% CI: 0.34-0.69), p<0.001. CONCLUSIONS: Treatment with immunomodulators seems to reduce long-term probability of disability progression. Additional well-designed observational studies could help to confirm these findings.
Authors: Damiano Paolicelli; Giuseppe Lucisano; Alessia Manni; Carlo Avolio; Simona Bonavita; Vincenzo Brescia Morra; Marco Capobianco; Eleonora Cocco; Antonella Conte; Giovanna De Luca; Francesca De Robertis; Claudio Gasperini; Maurizia Gatto; Paola Gazzola; Giacomo Lus; Antonio Iaffaldano; Pietro Iaffaldano; Davide Maimone; Giulia Mallucci; Giorgia T Maniscalco; Girolama A Marfia; Francesco Patti; Ilaria Pesci; Carlo Pozzilli; Marco Rovaris; Giuseppe Salemi; Marco Salvetti; Daniele Spitaleri; Rocco Totaro; Mauro Zaffaroni; Giancarlo Comi; Maria Pia Amato; Maria Trojano Journal: J Neurol Date: 2019-09-18 Impact factor: 4.849
Authors: Georgios K Vasileiadis; Efthymios Dardiotis; Athanasios Mavropoulos; Zisis Tsouris; Vana Tsimourtou; Dimitrios P Bogdanos; Lazaros I Sakkas; Georgios M Hadjigeorgiou Journal: Auto Immun Highlights Date: 2018-11-10
Authors: J William L Brown; Alasdair Coles; Dana Horakova; Eva Havrdova; Guillermo Izquierdo; Alexandre Prat; Marc Girard; Pierre Duquette; Maria Trojano; Alessandra Lugaresi; Roberto Bergamaschi; Pierre Grammond; Raed Alroughani; Raymond Hupperts; Pamela McCombe; Vincent Van Pesch; Patrizia Sola; Diana Ferraro; Francois Grand'Maison; Murat Terzi; Jeannette Lechner-Scott; Schlomo Flechter; Mark Slee; Vahid Shaygannejad; Eugenio Pucci; Franco Granella; Vilija Jokubaitis; Mark Willis; Claire Rice; Neil Scolding; Alastair Wilkins; Owen R Pearson; Tjalf Ziemssen; Michael Hutchinson; Katharine Harding; Joanne Jones; Christopher McGuigan; Helmut Butzkueven; Tomas Kalincik; Neil Robertson Journal: JAMA Date: 2019-01-15 Impact factor: 56.272