Krankheitsmodifizierende Therapie der sekundär progredienten Multiplen Sklerose

Hoffmann, Olaf; Gold, Ralf

doi:10.1007/s00115-021-01080-6

Cited by 3 publications

(1 citation statement)

References 52 publications

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“…The gradual recognition of its effect has caused the evolution of this PMS treatment ( 11 ). At present, the mainstream treatment for PMS is DMTs, which can delay the progression of the disease and reduce the deterioration of the disease by oral or injectable DMT-related drugs ( 12 ). Currently, more than 10 drugs are included in DMT therapy, including ocrelizumab, natalizumab, rituximab (RTX), laquinimod, siponimod, fingolimod, interferon-beta-1b (IFN-beta-1b), interferon-beta-1a (IFN-beta-1a), glatiramer acetate (GA), mitoxantrone, and dimethyl fumarate (DF) ( 13 ).…”

Section: Introductionmentioning

confidence: 99%

Disease-modifying therapy in progressive multiple sclerosis: a systematic review and network meta-analysis of randomized controlled trials

Wu,

Wang,

Xue

et al. 2024

Front. Neurol.

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BackgroundCurrently, disease-modifying therapies (DMTs) for progressive multiple sclerosis (PMS) are widely used in clinical practice. At the same time, there are a variety of drug options for DMTs, but the effect of the drugs that can better relieve symptoms and improve the prognosis are still inconclusive.ObjectivesThis systematic review aimed to evaluate the efficacy and safety of DMTs for PMS and to identify the best among these drugs.MethodsMEDLINE, EMBASE, the Cochrane Library, and clinicaltrials.gov were systematically searched to identify relevant studies published before 30 January, 2023. We assessed the certainty of the evidence using the confidence in the network meta-analysis (CINeMA) framework. We estimated the summary risk ratio (RR) for dichotomous outcomes and mean differences (MD) for continuous outcomes with 95% credible intervals (CrIs).ResultsWe included 18 randomized controlled trials (RCTs) involving 9,234 patients in the study. DMT can effectively control the disease progression of MS. Among them, mitoxantrone, siponimod, and ocrelizumab are superior to other drug options in delaying disease progression (high certainty). Mitoxantrone was the best (with high certainty) for mitigating deterioration (progression of disability). Ocrelizumab performed best on the pre- and post-treatment Timed 25-Foot Walk test (T25FW; low certainty), as did all other agents (RR range: 1.12–1.05). In the 9-Hole Peg Test (9HPT), natalizumab performed the best (high certainty), as did all other agents (RR range: 1.59–1.09). In terms of imaging, IFN-beta-1b performed better on the new T2 hypointense lesion on contrast, before and after treatment (high certainty), while siponimod performed best on the change from baseline in the total volume of lesions on T2-weighted image contrast before and after treatment (high certainty), and sWASO had the highest area under the curve (SUCRA) value (100%). In terms of adverse events (AEs), rituximab (RR 1.01), and laquinimod (RR 1.02) were more effective than the placebo (high certainty). In terms of serious adverse events (SAEs), natalizumab (RR 1.09), and ocrelizumab (RR 1.07) were safer than placebo (high certainty).ConclusionDMTs can effectively control disease progression and reduce disease deterioration during the treatment of PMS.Systematic review registrationhttps://inplasy.com/?s=202320071, identifier: 202320071.

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Section: Introductionmentioning

confidence: 99%

Disease-modifying therapy in progressive multiple sclerosis: a systematic review and network meta-analysis of randomized controlled trials

Wu,

Wang,

Xue

et al. 2024

Front. Neurol.

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Ocrelizumab in highly disabled progressive multiple sclerosis patients

Houtchens,

Howard

2024

Multiple Sclerosis and Related Disorders

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Anhalten der Behinderungsprogression unter Siponimod bei sekundär chronisch progredienter Multipler Sklerose

Bartzokis

2024

Nervenheilkunde

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ZUSAMMENFASSUNGIm klinischen Alltag ist der Übergang von der schubförmig-remittierenden Multiplen Sklerose (RRMS) in die sekundär chronisch progrediente Form (SPMS) fließend und in den meisten Fällen mangels valider Diagnosekriterien retrospektiv zu stellen. Es wird über den Verlauf eines 41-jährigen männlichen Patienten mit einer ursprünglichen hochaktiven Verlaufsform berichtet, der unter einer Therapie mit dem Sphingosin-1-Phosphats-Rezeptormodulator Fingolimod eine schubunabhängige Behinderungsprogression aufwies, welche sowohl durch eine Score-Zunahme auf der Expanded Disability Status Scale (EDSS) als auch durch eine weitere Verschlechterung seiner neurogenen Blasenfunktionsstörung objektiviert werden konnte. Nach Umstellung auf Siponimod blieben sowohl der EDSS-Score als auch die Gangfähigkeit, die Blasenfunktion sowie das Sehvermögen stabil. Diskutiert werden kann zum einen der duale Wirkmechanismus mit Einfluss auf periphere sowie ZNS-intrinsische Inflammation und zum anderen die Lipophilie der Substanz mit sehr guter ZNS-Gängigkeit, wodurch eine effektive zentrale Wirkung auf Oligondendrozyten anzunehmen ist.

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Krankheitsmodifizierende Therapie der sekundär progredienten Multiplen Sklerose

Cited by 3 publications

References 52 publications

Disease-modifying therapy in progressive multiple sclerosis: a systematic review and network meta-analysis of randomized controlled trials

Disease-modifying therapy in progressive multiple sclerosis: a systematic review and network meta-analysis of randomized controlled trials

Ocrelizumab in highly disabled progressive multiple sclerosis patients

Anhalten der Behinderungsprogression unter Siponimod bei sekundär chronisch progredienter Multipler Sklerose

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