A meta-analysis comparing first-line immunosuppressants in neuromyelitis optica
NEMOS (Neuromyelitis Optica Study Group in Germany), NOMADMUS (Neuromyelitis Optica study Group in France), OFSEP (Observatoire Français de la Sclérose en Plaques) investigators
Neurology & Neurotherapeutics
NE-Core NTRC
Neurology & Neurotherapeutics - NE Multiple Sclerosis Section
Objective: As phase III trials have shown interest in innovative but expensive drugs in the treatment of neuromyelitis optica spectrum disorder (NMOSD), data are needed to clarify strategies in the treatment of neuromyelitis optica (NMO). This meta-analysis compares the efficacy of first-line strategies using rituximab (RTX), mycophenolate mofetil (MMF), or azathioprine (AZA), which are still widely used. Methods: Studies identified by the systematic review of Huang et al. (2019) were selected if they considered at least two first-line immunosuppressants among RTX, MMF, and AZA. We updated this review. The Medline, Cochrane Central Register of Controlled Trials, Embase, and ClinicalTrials databases were queried between November 2018 and April 2020. To be included, the hazard ratio (HR) [95% CI] for the time to first relapse after first-line immunosuppression had to be available, calculable, or provided by the authors. Results: We gathered data from 919 NMO patients (232 RTX-, 294 MMF-, and 393 AZA-treated patients). The risk of first relapse after first-line immunosuppression was 1.55 [1.04, 2.31] (p = 0.03) for MMF compared with RTX, 1.42 [0.87, 2.30] (p = 0.16) for AZA compared with RTX, and 0.94 [0.58, 1.54] (p = 0.08) for MMF compared with AZA. Interpretation: The findings suggest that RTX is more efficient than MMF as a first-line therapy. Even if the results of our meta-analysis cannot conclude that RTX has a better efficacy in delaying the first relapse than AZA, the observed effect difference between both treatments combined with the results of previous studies using as outcome the annualized relapse rate may be in favor of RTX.
Annals of Clinical and Translational Neurology
https://doi.org/10.1002/acn3.51451
10.1002/acn3.51451
Dive into the research topics of 'A meta-analysis comparing first-line immunosuppressants in neuromyelitis optica'. Together they form a unique fingerprint.
Neuromyelitis Optica Medicine & Life Sciences 100%
Rituximab Medicine & Life Sciences 80%
Mycophenolic Acid Medicine & Life Sciences 65%
Azathioprine Medicine & Life Sciences 61%
Immunosuppressive Agents Medicine & Life Sciences 61%
Recurrence Medicine & Life Sciences 21%
Immunosuppression Medicine & Life Sciences 16%
NEMOS (Neuromyelitis Optica Study Group in Germany), NOMADMUS (Neuromyelitis Optica study Group in France), OFSEP (Observatoire Français de la Sclérose en Plaques) investigators (2021). A meta-analysis comparing first-line immunosuppressants in neuromyelitis optica. Annals of Clinical and Translational Neurology, 8(10), 2025-2037. https://doi.org/10.1002/acn3.51451
A meta-analysis comparing first-line immunosuppressants in neuromyelitis optica. / NEMOS (Neuromyelitis Optica Study Group in Germany), NOMADMUS (Neuromyelitis Optica study Group in France), OFSEP (Observatoire Français de la Sclérose en Plaques) investigators.
In: Annals of Clinical and Translational Neurology, Vol. 8, No. 10, 10.2021, p. 2025-2037.
NEMOS (Neuromyelitis Optica Study Group in Germany), NOMADMUS (Neuromyelitis Optica study Group in France), OFSEP (Observatoire Français de la Sclérose en Plaques) investigators 2021, 'A meta-analysis comparing first-line immunosuppressants in neuromyelitis optica', Annals of Clinical and Translational Neurology, vol. 8, no. 10, pp. 2025-2037. https://doi.org/10.1002/acn3.51451
NEMOS (Neuromyelitis Optica Study Group in Germany), NOMADMUS (Neuromyelitis Optica study Group in France), OFSEP (Observatoire Français de la Sclérose en Plaques) investigators. A meta-analysis comparing first-line immunosuppressants in neuromyelitis optica. Annals of Clinical and Translational Neurology. 2021 Oct;8(10):2025-2037. https://doi.org/10.1002/acn3.51451
NEMOS (Neuromyelitis Optica Study Group in Germany), NOMADMUS (Neuromyelitis Optica study Group in France), OFSEP (Observatoire Français de la Sclérose en Plaques) investigators. / A meta-analysis comparing first-line immunosuppressants in neuromyelitis optica. In: Annals of Clinical and Translational Neurology. 2021 ; Vol. 8, No. 10. pp. 2025-2037.
@article{e7f1bb4c97204c38b14516e20734fb2e,
title = "A meta-analysis comparing first-line immunosuppressants in neuromyelitis optica",
abstract = "Objective: As phase III trials have shown interest in innovative but expensive drugs in the treatment of neuromyelitis optica spectrum disorder (NMOSD), data are needed to clarify strategies in the treatment of neuromyelitis optica (NMO). This meta-analysis compares the efficacy of first-line strategies using rituximab (RTX), mycophenolate mofetil (MMF), or azathioprine (AZA), which are still widely used. Methods: Studies identified by the systematic review of Huang et al. (2019) were selected if they considered at least two first-line immunosuppressants among RTX, MMF, and AZA. We updated this review. The Medline, Cochrane Central Register of Controlled Trials, Embase, and ClinicalTrials databases were queried between November 2018 and April 2020. To be included, the hazard ratio (HR) [95% CI] for the time to first relapse after first-line immunosuppression had to be available, calculable, or provided by the authors. Results: We gathered data from 919 NMO patients (232 RTX-, 294 MMF-, and 393 AZA-treated patients). The risk of first relapse after first-line immunosuppression was 1.55 [1.04, 2.31] (p = 0.03) for MMF compared with RTX, 1.42 [0.87, 2.30] (p = 0.16) for AZA compared with RTX, and 0.94 [0.58, 1.54] (p = 0.08) for MMF compared with AZA. Interpretation: The findings suggest that RTX is more efficient than MMF as a first-line therapy. Even if the results of our meta-analysis cannot conclude that RTX has a better efficacy in delaying the first relapse than AZA, the observed effect difference between both treatments combined with the results of previous studies using as outcome the annualized relapse rate may be in favor of RTX.",
author = "{NEMOS (Neuromyelitis Optica Study Group in Germany), NOMADMUS (Neuromyelitis Optica study Group in France), OFSEP (Observatoire Fran{\c c}ais de la Scl{\'e}rose en Plaques) investigators} and Jonathan Giovannelli and Jonathan Ciron and Mikael Cohen and Kim, {Ho Jin} and Kim, {Su Hyun} and Stellmann, {Jan Patrik} and Ingo Kleiter and Morgan McCreary and Greenberg, {Benjamin M.} and Romain Deschamps and Bertrand Audoin and Elisabeth Maillart and Caroline Papeix and Nicolas Collongues and Bertrand Bourre and David Laplaud and Xavier Ayrignac and Fran{\c c}oise Durand-Dubief and Aur{\'e}lie Ruet and Sandra Vukusic and Romain Marignier and Luc Dauchet and H{\'e}l{\`e}ne Zephir",
note = "Funding Information: No funding information provided. Publisher Copyright: {\textcopyright} 2021 The Authors. Annals of Clinical and Translational Neurology published by Wiley Periodicals LLC on behalf of American Neurological Association",
doi = "10.1002/acn3.51451",
journal = "Annals of Clinical and Translational Neurology",
T1 - A meta-analysis comparing first-line immunosuppressants in neuromyelitis optica
AU - NEMOS (Neuromyelitis Optica Study Group in Germany), NOMADMUS (Neuromyelitis Optica study Group in France), OFSEP (Observatoire Français de la Sclérose en Plaques) investigators
AU - Giovannelli, Jonathan
AU - Ciron, Jonathan
AU - Cohen, Mikael
AU - Kim, Ho Jin
AU - Kim, Su Hyun
AU - Stellmann, Jan Patrik
AU - Kleiter, Ingo
AU - McCreary, Morgan
AU - Greenberg, Benjamin M.
AU - Deschamps, Romain
AU - Audoin, Bertrand
AU - Maillart, Elisabeth
AU - Papeix, Caroline
AU - Collongues, Nicolas
AU - Bourre, Bertrand
AU - Laplaud, David
AU - Ayrignac, Xavier
AU - Durand-Dubief, Françoise
AU - Ruet, Aurélie
AU - Vukusic, Sandra
AU - Marignier, Romain
AU - Dauchet, Luc
AU - Zephir, Hélène
N1 - Funding Information: No funding information provided. Publisher Copyright: © 2021 The Authors. Annals of Clinical and Translational Neurology published by Wiley Periodicals LLC on behalf of American Neurological Association
N2 - Objective: As phase III trials have shown interest in innovative but expensive drugs in the treatment of neuromyelitis optica spectrum disorder (NMOSD), data are needed to clarify strategies in the treatment of neuromyelitis optica (NMO). This meta-analysis compares the efficacy of first-line strategies using rituximab (RTX), mycophenolate mofetil (MMF), or azathioprine (AZA), which are still widely used. Methods: Studies identified by the systematic review of Huang et al. (2019) were selected if they considered at least two first-line immunosuppressants among RTX, MMF, and AZA. We updated this review. The Medline, Cochrane Central Register of Controlled Trials, Embase, and ClinicalTrials databases were queried between November 2018 and April 2020. To be included, the hazard ratio (HR) [95% CI] for the time to first relapse after first-line immunosuppression had to be available, calculable, or provided by the authors. Results: We gathered data from 919 NMO patients (232 RTX-, 294 MMF-, and 393 AZA-treated patients). The risk of first relapse after first-line immunosuppression was 1.55 [1.04, 2.31] (p = 0.03) for MMF compared with RTX, 1.42 [0.87, 2.30] (p = 0.16) for AZA compared with RTX, and 0.94 [0.58, 1.54] (p = 0.08) for MMF compared with AZA. Interpretation: The findings suggest that RTX is more efficient than MMF as a first-line therapy. Even if the results of our meta-analysis cannot conclude that RTX has a better efficacy in delaying the first relapse than AZA, the observed effect difference between both treatments combined with the results of previous studies using as outcome the annualized relapse rate may be in favor of RTX.
AB - Objective: As phase III trials have shown interest in innovative but expensive drugs in the treatment of neuromyelitis optica spectrum disorder (NMOSD), data are needed to clarify strategies in the treatment of neuromyelitis optica (NMO). This meta-analysis compares the efficacy of first-line strategies using rituximab (RTX), mycophenolate mofetil (MMF), or azathioprine (AZA), which are still widely used. Methods: Studies identified by the systematic review of Huang et al. (2019) were selected if they considered at least two first-line immunosuppressants among RTX, MMF, and AZA. We updated this review. The Medline, Cochrane Central Register of Controlled Trials, Embase, and ClinicalTrials databases were queried between November 2018 and April 2020. To be included, the hazard ratio (HR) [95% CI] for the time to first relapse after first-line immunosuppression had to be available, calculable, or provided by the authors. Results: We gathered data from 919 NMO patients (232 RTX-, 294 MMF-, and 393 AZA-treated patients). The risk of first relapse after first-line immunosuppression was 1.55 [1.04, 2.31] (p = 0.03) for MMF compared with RTX, 1.42 [0.87, 2.30] (p = 0.16) for AZA compared with RTX, and 0.94 [0.58, 1.54] (p = 0.08) for MMF compared with AZA. Interpretation: The findings suggest that RTX is more efficient than MMF as a first-line therapy. Even if the results of our meta-analysis cannot conclude that RTX has a better efficacy in delaying the first relapse than AZA, the observed effect difference between both treatments combined with the results of previous studies using as outcome the annualized relapse rate may be in favor of RTX.
U2 - 10.1002/acn3.51451
DO - 10.1002/acn3.51451
JO - Annals of Clinical and Translational Neurology
JF - Annals of Clinical and Translational Neurology