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The long-term effects of disease modifying therapies on disability in people living with multiple sclerosis: a systematic review and meta-analysis
Methods: We searched the EMBASE and Medline databases in January 2018, using search terms that included DMT and relevant outcome measures. Two authors screened all resulting studies and evaluated the risk of bias of included studies using the ROBINS-I tool for non-randomized studies. Where there was sufficient data, we performed meta-analyses using RevMan 5. Studies that could not be included in a meta-analysis were included in data synthesis.
Results: Our search returned 7,766 unique articles for review. After screening, 18 articles were included. Follow-up in these studies ranged from a mean of 3.9 years to a median of 17.8 years. Fifteen (83.3%) of the included studies had a moderate risk of bias and three (16.7%) had a serious risk of bias. Meta-analysis showed that DMT significantly reduced the risk of EDSS 6.0 and SPMS compared to no treatment.
Conclusion: There is some evidence that long-term treatment with interferon beta reduces the risk of EDSS 6.0 and SPMS compared to no treatment or placebo. More work is needed on the effect of second generation DMT and the relative effect of DMT on health outcomes.
History
Publication title
Multiple Sclerosis and Related DisordersVolume
36Article number
101374Number
101374Pagination
1-10ISSN
2211-0348Department/School
Menzies Institute for Medical ResearchPublisher
Elsevier BVPlace of publication
NetherlandsRights statement
© 2019 Published by Elsevier B.V.Repository Status
- Restricted