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- W2545790711 abstract "Comparative effectiveness of disease modifying therapies (DMTs) is required to inform clinical care and health policy. We performed a network meta-analysis (NMA) to estimate the relative efficacy of DMTs versus placebo and of GA versus other DMTs. Systematic searches (September 2015) were conducted in MEDLINE, Embase, and Cochrane Library to identify RCTs evaluating alemtuzumab, daclizumab, dimethyl-fumarate, fingolimod, GA, interferon beta-1a, interferon beta-1b, laquinimod, natalizumab, ocrelizumab, peginterferon beta-1a and teriflunomide. The outcomes (ARR and 3 or 6 months confirmed disability progression [CDP]) were analysed using Bayesian random effects models. The NMA for ARR and CDP included 34 and 32 RCTs, respectively. All DMTs showed significant reductions in ARR vs placebo (18%-72%). GA significantly reduced ARR vs placebo (median rate ratio: 0.65, 95% CrI:0.58-0.71) and compared to interferon beta-1a 3mcg, laquinimod and teriflunomide, but showed significantly higher ARRs vs daclizumab, dimethyl-fumarate, fingolimod, natalizumab and ocrelizumab. No significant differences with the other DMTs were observed. DMTs showed variable protective effects on CDP vs placebo (HR 0.41-0.90). Alemtuzumab showed the highest significant protective effect (HR 0.41[95%Crl 0.27-0.63]) and interferon beta-1a 30mcg the least (HR 0.76[95%Crl 0.61-0.95]). The median HR for GA was 0.74(95%CrI 0.59-0.92), which was significant and in line with the 6-year results of the UK Risk Sharing Scheme cohort study showing a 30.3% reduction in disability progression with GA vs no treatment [Sumra 2015]. GA was less effective compared to alemtuzumab and natalizumab but showed similar benefit vs all other DMT’s on disability protection. A high degree of uncertainty was observed likely due to the heterogeneity found in the definition of CDP. NMA demonstrated significant reductions in ARR for all DMTs vs placebo and similar efficacy between GA and other DMTs. GA showed significant disability benefit vs no treatment, in line with long term RSS data." @default.
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- W2545790711 date "2016-11-01" @default.
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- W2545790711 title "Glatiramer Acetate (Ga) Results in Significant Reductions in Annualized Relapse Rate (Arr) and Protective Effect on Disibiltiy Progression: Results From a Network Meta-Analysis" @default.
- W2545790711 doi "https://doi.org/10.1016/j.jval.2016.09.462" @default.
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