Siyuan Yang1, Xiang Li1, Jiahe Wang1, Tianyi Wang1, Zhongmou Xu1, Heng Gao2, Gang Chen1. 1. Department of Clinical Medicine, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China. 2. Department of Clinical Medicine, The Affiliated Jiangyin Hospital, School of Medicine, Southeast University, No. 3 yingrui road, Jiangyin, 214400, Jiangsu Province, China. brainsurgeon@163.com.
Abstract
BACKGROUND: As one kind of disease-modifying therapies, sphingosine-1-phosphate receptor (S1PR) modulators such as fingolimod, ozanimod, and siponimod have been approved or are being developed to treat multiple sclerosis (MS). Several randomized controlled trials (RCT) have been implemented to compare the efficacy and safety of S1PR modulators versus interferon beta in the treatment of people with relapsing-remitting multiple sclerosis (RRMS). METHOD: We searched RCTs which were implemented from January 2010 to June 2020 by searching PubMed, Embase, Cochrane Library databases, and the Central Register of Controlled Trials. Finally, five RCTs were included in our study after carefully choosing. RESULT: We pooled 4304 patients from 5 RCTs. The primary outcome was the annualized relapse rate. We found that the annualized relapse rate in the S1PR modulator group is 20% less than that in the interferon beta group (95%CI, - 0.32 to - 0.07, P = 0.002). S1PR modulators led to a significant reduction in number of new or enlarging T2 lesions per scan and number of gadolinium-enhancing lesions compared with interferon beta. Moreover, S1PR modulators can also improve 54-item multiple sclerosis quality of life (MSQOL-54) physical health composite score (P = 0.0005). CONCLUSION: S1PR modulators exhibited good efficacy and safety for the treatment of RRMS compared with interferon beta. According to follow-up trials, S1PR modulators can improve MSQOL-54 physical health composite score so that it may be beneficial to neurological recovery which need more research to confirm.
BACKGROUND: As one kind of disease-modifying therapies, sphingosine-1-phosphate receptor (S1PR) modulators such as fingolimod, ozanimod, and siponimod have been approved or are being developed to treat multiple sclerosis (MS). Several randomized controlled trials (RCT) have been implemented to compare the efficacy and safety of S1PR modulators versus interferon beta in the treatment of people with relapsing-remitting multiple sclerosis (RRMS). METHOD: We searched RCTs which were implemented from January 2010 to June 2020 by searching PubMed, Embase, Cochrane Library databases, and the Central Register of Controlled Trials. Finally, five RCTs were included in our study after carefully choosing. RESULT: We pooled 4304 patients from 5 RCTs. The primary outcome was the annualized relapse rate. We found that the annualized relapse rate in the S1PR modulator group is 20% less than that in the interferon beta group (95%CI, - 0.32 to - 0.07, P = 0.002). S1PR modulators led to a significant reduction in number of new or enlarging T2 lesions per scan and number of gadolinium-enhancing lesions compared with interferon beta. Moreover, S1PR modulators can also improve 54-item multiple sclerosis quality of life (MSQOL-54) physical health composite score (P = 0.0005). CONCLUSION: S1PR modulators exhibited good efficacy and safety for the treatment of RRMS compared with interferon beta. According to follow-up trials, S1PR modulators can improve MSQOL-54 physical health composite score so that it may be beneficial to neurological recovery which need more research to confirm.
Authors: Ludwig Kappos; Jack Antel; Giancarlo Comi; Xavier Montalban; Paul O'Connor; Chris H Polman; Tomas Haas; Alexander A Korn; Goeril Karlsson; Ernst W Radue Journal: N Engl J Med Date: 2006-09-14 Impact factor: 91.245
Authors: Ludwig Kappos; Ernst-Wilhelm Radue; Paul O'Connor; Chris Polman; Reinhard Hohlfeld; Peter Calabresi; Krzysztof Selmaj; Catherine Agoropoulou; Malgorzata Leyk; Lixin Zhang-Auberson; Pascale Burtin Journal: N Engl J Med Date: 2010-01-20 Impact factor: 91.245
Authors: Jeffrey A Cohen; Frederik Barkhof; Giancarlo Comi; Hans-Peter Hartung; Bhupendra O Khatri; Xavier Montalban; Jean Pelletier; Ruggero Capra; Paolo Gallo; Guillermo Izquierdo; Klaus Tiel-Wilck; Ana de Vera; James Jin; Tracy Stites; Stacy Wu; Shreeram Aradhye; Ludwig Kappos Journal: N Engl J Med Date: 2010-01-20 Impact factor: 91.245