Subgroups of multiple sclerosis patients with larger treatment benefits: a meta-analysis of randomized trials

: Multiple sclerosis (MS) is a chronic neurodegenerative, inflammatory and autoimmune disease characterised by the demyelination of the central nervous system. One of the main approaches to treating MS is the use of disease-modifying therapies (DMTs). Among the DMTs are interferons (IFNs), which are cytokines responsible for controlling the activity of the immune system, exerting immunomodulatory, antiviral, and antiproliferative activities. IFN-beta (IFN-β) is the first-choice drug used to treat relapsing-remitting MS. However, the administration of IFN-β causes numerous painful adverse effects, resulting in lower adherence to the treatment. Therefore, this study aimed to investigate the headache and flu-like pain symptoms observed after IFNβ injection in MS patients using a systematic review and meta-analysis of randomised controlled trials. The search of research databases identified 2370 articles. Nine articles were included (three involving IFNβ-1b and six involving IFNβ-1a). All studies included in the meta-analysis had a low risk of bias. Headache and flu-like pain symptoms frequency increased in MS patients treated with IFN-β. Thus, the adverse effects of headache and flu-like pain symptoms appear to be linked to IFN-β treatment in MS. The protocol of the study was registered in the Prospective International Registry of Systematic Reviews.

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NLRP3 polymorphisms and response to interferon-beta in multiple sclerosis patients

Multiple Sclerosis Journal ◽

10.1177/1352458517739137 ◽

2017 ◽

Vol 24 (11) ◽

pp. 1507-1510 ◽

Cited By ~ 4

Author(s):

Sunny Malhotra ◽

Melissa Sorosina ◽

Jordi Río ◽

Silvia Peroni ◽

Luciana Midaglia ◽

...

Keyword(s):

Multiple Sclerosis ◽

Interferon Beta ◽

Meta Analysis ◽

Nlrp3 Gene ◽

Radiological Criteria ◽

Pyrin Domain ◽

Relapsing Remitting ◽

Multiple Sclerosis Patients

We aimed to investigate whether NLR family, pyrin domain containing 3 (NLRP3) polymorphisms are associated with the response to interferon-beta (IFNβ) in multiple sclerosis (MS) patients. A total of 14 NLRP3 polymorphisms were genotyped in a cohort of 665 relapsing-remitting MS patients recruited across 5 centers and classified into responders and non-responders according to clinical-radiological criteria after 1 year of IFNβ treatment. A meta-analysis failed to demonstrate significant associations between the response to IFNβ and NLRP3 polymorphisms. These findings do not support a role of polymorphisms located in the NLRP3 gene and the response to IFNβ in MS patients.

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Effect of Exercise on Fatigue in Multiple Sclerosis Patients: A Network Meta-analysis

International Journal of Sports Medicine ◽

10.1055/a-1524-1935 ◽

2021 ◽

Author(s):

Yuting Chen ◽

Shanshan Xu ◽

Jiran Shen ◽

Hui Yang ◽

Wei Xu ◽

...

Keyword(s):

Multiple Sclerosis ◽

Web Of Science ◽

Meta Analysis ◽

Cochrane Library ◽

Control Group ◽

Inclusion Criteria ◽

Randomized Controlled ◽

Different Types ◽

Multiple Sclerosis Patients ◽

Better Than

AbstractFew studies have directly compared the effects of different exercise therapies on reducing fatigue in patients with multiple sclerosis. Thus, we conducted a Frequentist network meta-analysis to analyze and compare the effectiveness of different types of exercise on reducing multiple sclerosis-related fatigue. Relevant randomized controlled trials were searched in PubMed, Web of Science and Cochrane Library databases from the date of their inception up to April 1, 2021. In total, 27 articles involving 1470 participants and 10 types of interventions met the inclusion criteria. The results indicated that aquatic exercise ranked as the most effective among these interventions, and aerobic exercise had small-to-moderate effect sizes. Most of the interventions were shown to be better than the control group, except for climbing. Climbing was the only intervention that ranked worse than the controls. All of these findings merit further investigation in future clinical trials.

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Cerebrospinal Fluid and Blood Cytokines as Biomarkers for Multiple Sclerosis: A Systematic Review and Meta-Analysis of 226 Studies With 13,526 Multiple Sclerosis Patients

Frontiers in Neuroscience ◽

10.3389/fnins.2019.01026 ◽

2019 ◽

Vol 13 ◽

Cited By ~ 8

Author(s):

Zhile Bai ◽

Duanduan Chen ◽

Luyao Wang ◽

Yu Zhao ◽

Tiantian Liu ◽

...

Keyword(s):

Multiple Sclerosis ◽

Systematic Review ◽

Cerebrospinal Fluid ◽

Meta Analysis ◽

Blood Cytokines ◽

Multiple Sclerosis Patients

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Effects of Vitamin D Supplementation on Inflammatory Markers in Multiple Sclerosis Patients: A Systematic Review and Meta-Analysis

Journal of Archives in Military Medicine ◽

10.5812/jamm.112426 ◽

2021 ◽

Vol 9 (1) ◽

Author(s):

Shima Mehrabadi ◽

Elham Zahedi

Keyword(s):

Multiple Sclerosis ◽

Clinical Trial ◽

Vitamin D ◽

Randomized Clinical Trial ◽

Meta Analysis ◽

Total Sample ◽

Vitamin D Supplementation ◽

Online Databases ◽

Ifn Γ ◽

Multiple Sclerosis Patients

Context: Numerous studies have indicated that vitamin D can modulate the immune system and plays an important role in regulating immune cells’ functions. Some clinical studies have assessed the effect of vitamin D supplementation on cytokine markers in multiple sclerosis (MS) as a disease in which the immune system’s function is disrupted. Evidence Acquisition: This study was designed to assess randomized clinical trial studies evaluating the overall effect of vitamin D on the levels of IL-10, IL-17, and IFN-γ in MS patients. Methods: We searched PubMed and Scopus online databases up to November 2020 for relevant randomized clinical trial studies by using certain keywords. Eight studies from 273 articles, with a total sample of 443 participants, were considered Results: The meta-analysis indicated that vitamin D consumption did not significantly change the levels of IL-10 (WMD : -174.56, 95% CI: -373.10 to 23.98), IL-17 (WMD : -0.11, 95% CI: -0.54.10 to 0.33), or IFN-γ (WMD : 61.47, 95% CI: 43.96 to 78.98) in MS patients. Conclusions: Further clinical trials are warranted to evaluate the effects of vitamin D supplement on IL-10 and IL-17, and INFγ levels in MS patients.

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Memantine for Multiple Sclerosis: A Systematic Review and Meta-Analysis of Randomized Trials

Frontiers in Neurology ◽

10.3389/fneur.2020.574748 ◽

2021 ◽

Vol 11 ◽

Author(s):

Christian Wilson R. Turalde ◽

Adrian I. Espiritu ◽

Veeda Michelle M. Anlacan

Keyword(s):

Multiple Sclerosis ◽

Cognitive Impairment ◽

Randomized Trials ◽

Adverse Drug Events ◽

Demyelinating Disease ◽

Meta Analysis ◽

Glutamate Toxicity ◽

Efficacy And Safety ◽

Disease Modifying Therapies ◽

The Central Nervous System

Background: Multiple sclerosis (MS), a disabling demyelinating disease of the central nervous system, is associated with cognitive impairment, spasticity, and fatigue. There are still no established guidelines on the management of MS-related sequela. Memantine has the potential to reduce glutamate toxicity, thereby reducing consequent cognitive impairment, spasticity, and fatigue.Objectives: This study aims to determine the efficacy and safety of memantine in preventing cognitive impairment, reducing spasticity and fatigue, and controlling disability in MS patients through a review of relevant randomized trials.Methods: MEDLINE, CENTRAL, Scopus, Embase, LILACS, ClinicalTrials.gov, and HERDIN were searched from inception to May 2020 for relevant trials.Results: The search yielded 203 articles; four studies were included in the analysis. Pooled evidence shows that memantine compared with placebo does not significantly improve PASAT, ASS, MFIS, and EDSS scores of patients with MS. Memantine is associated with mild adverse drug events such as dizziness, fatigue, and anxiety.Conclusion: There is not enough evidence to support the efficacy of memantine in preventing cognitive decline, controlling spasticity, reducing fatigue, and preventing disability. Future researches should consider the different MS subtypes, effect of co-administration of disease-modifying therapies, longer duration of administration, and more sensitive outcome measures to evaluate the potential benefit of memantine in MS.

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