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Neurological Sciences

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01-05-2021 | Multiple Sclerosis | Review Article

Efficacy and acceptability of the S1P receptor in the treatment of multiple sclerosis: a meta-analysis

Authors: Jingyi Tong, Qin Zou, Yongmin Chen, Xiaoping Liao, Rong Chen, Lin Ma, Daqi Zhang, Qifu Li

Published in: Neurological Sciences | Issue 5/2021

Abstract

Background and objective

Sphingosine-1-phosphate (S1P) receptors are extensively used in the treatment of multiple sclerosis (MS). However, the optimal therapeutic role of S1P in MS patients has still remained elusive. This network meta-analysis (NMA) systematically evaluated the efficacy and acceptability of S1P receptors, as disease-modifying drugs, in the treatment of patients with MS, so as to find out the most appropriate therapeutic strategy and provide a reliable basis for the prescription of S1P drugs for patients with MS.

Methods

We conducted a systematic review and NMA to compare the efficacy and acceptability of S1P receptors for treating MS patients. Randomized controlled trials (RCTs), which were published until May 2020, were retrieved from the PubMed, Cochrane Library, Embase, and ClinicalTrials.gov databases. The primary outcome in this study was the treatment efficacy for the S1P receptor for MS patients, in terms of decrease in annualized relapse rate. The secondary outcomes were adverse events leading to discontinuation of a study, such as an unfavorable or unintended sign/symptom. Outcomes were appraised using a random effects model expressed as standardized mean differences (SMDs) and risk ratios (RRs) with 95% confidence intervals (CIs), respectively, and were ranked using surface under the cumulative ranking curve (SUCRA) probabilities for hierarchical clustering of interventions.

Results

A total of 13 RCTS were included, which enrolled 10,554 patients. The results of NMA showed that Fingolimod, Laquinimod, Siponimod, Ozanimod, Amiselimod, and Ponesimod were superior to placebo in terms of reducing the annualized relapse rate of MS patients. Regarding efficacy, the best and worst treatments were Amiselimod (0.4 mg; SUCRA 8.1%) and placebo (SUCRA 90.5%), respectively. As for acceptability, the best and worst interventions were Ozanimod (1 mg; SUCRA 20.4%) and Ponesimod (40 mg; SUCRA 96.0%), respectively. The comparison-adjusted funnel plots of annualized relapse rate and side effects in the included studies revealed that there was no significant funnel plot asymmetry

Conclusions

This NMA indicated that Amiselimod (0.4 mg) is the most effective treatment strategy as a S1P receptor for MS patients. However, the abovementioned findings need to be further confirmed in the next researches.

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Title: Efficacy and acceptability of the S1P receptor in the treatment of multiple sclerosis: a meta-analysis
Authors: Jingyi Tong
Qin Zou
Yongmin Chen
Xiaoping Liao
Rong Chen
Lin Ma
Daqi Zhang
Qifu Li
Publication date: 01-05-2021
Publisher: Springer International Publishing
Keywords: Multiple Sclerosis
Fingolimod
Siponimod
Ponesimod
Ozanimod
Published in: Neurological Sciences / Issue 5/2021
Print ISSN: 1590-1874
Electronic ISSN: 1590-3478
DOI: https://doi.org/10.1007/s10072-021-05049-w

ACC 2024 Congress

Springer Medicine

Efficacy and acceptability of the S1P receptor in the treatment of multiple sclerosis: a meta-analysis

Abstract

Background and objective

Methods

Results

Conclusions

ACC 2024 Congress

Springer Medicine

Abstract

Background and objective

Methods

Results

Conclusions

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