SynthesisPloS one2015
The Effect of Disease Modifying Therapies on Disease Progression in Patients with Relapsing-Remitting Multiple Sclerosis: A Systematic Review and Meta-Analysis.
Synthesis in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- A Critical Systematic Review of Current Evidence on the Effects of Physical Exercise on Whole/Regional Grey Matter Brain Volume in Populations at Risk of Neurodegeneration.Sports medicine (Auckland, N.Z.) · 2021Pooled it
- Pooled it
- Clinical and Epidemiological Characteristics of Multiple Sclerosis in a Peruvian Cohort: A Retrospective Study Across Three Lima Hospitals.Neurology international · 2026Article
- Exit strategy patterns in second-line therapies for relapsing forms of multiple sclerosis.Acta neurologica Belgica · 2026Article
- Assessing disease progression and treatment response in progressive multiple sclerosis.Nature reviews. Neurology · 2024Review
- Article
- Beta interferons as immunotherapy in multiple sclerosis: a new outlook on a classic drug during the COVID-19 pandemic.QJM : monthly journal of the Association of Physicians · 2021Article
- Longitudinal analysis of T1w/T2w ratio in patients with multiple sclerosis from first clinical presentation.Multiple sclerosis (Houndmills, Basingstoke, England) · 2021Article
- Matching comparisons of therapeutic efficacy suggest better clinical outcomes for patients treated with peginterferon beta-1a than with glatiramer acetate.Therapeutic advances in neurological disorders · 2021Article
- Review
- Detecting neurodegenerative pathology in multiple sclerosis before irreversible brain tissue loss sets in.Translational neurodegeneration · 2019Review
- Th1Th17Mediators of inflammation · 2019Article
- Cladribine tablets added to IFN-β in active relapsing MS: The ONWARD study.Neurology(R) neuroimmunology & neuroinflammation · 2018Article
- The Effect of Disease Modifying Therapies on Disability Progression in Multiple Sclerosis: A Systematic Overview of Meta-Analyses.Frontiers in neurology · 2018Article
- Viruses and Multiple Sclerosis: From Mechanisms and Pathways to Translational Research Opportunities.Molecular neurobiology · 2017Review
- Gene variants of adhesion molecules act as modifiers of disease severity in MS.Neurology(R) neuroimmunology & neuroinflammation · 2017Article
- Multiple sclerosis animal models: a clinical and histopathological perspective.Brain pathology (Zurich, Switzerland) · 2017Review
- Successful utilization of the EMR in a multiple sclerosis clinic to support quality improvement and research initiatives at the point of care.Multiple sclerosis journal - experimental, translational and clinicalArticle
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
importanceA number of officially approved disease-modifying drugs (DMD) are currently available for the early intervention in patients with relapsing-remitting multiple sclerosis (RRMS). The aim of the present study was to systematically evaluate the effect of DMDs on disability progression in RRMS.
methodsWe performed a systematic review on MEDLINE and SCOPUS databases to include all available placebo-controlled randomized clinical trials (RCTs) of RRMS patients that reported absolute numbers or percentages of disability progression during each study period. Observational studies, case series, case reports, RCTs without placebo subgroups and studies reporting the use of RRMS therapies that are not still officially approved were excluded. Risk ratios (RRs) were calculated in each study protocol to express the comparison of disability progression in RRMS patients treated with a DMD and those RRMS patients receiving placebo. The mixed-effects model was used to calculate both the pooled point estimate in each subgroup and the overall estimates.
resultsDMDs for RRMS were found to have a significantly lower risk of disability progression compared to placebo (RR = 0.72, 95%CI: 0.66-0.79; p<0.001), with no evidence of heterogeneity or publication bias. In subsequent subgroup analyses, neither dichotomization of DMDs as "first" and "second" line RRMS therapies [(RR = 0.72, 95% CI = 0.65-0.80) vs. (RR = 0.72, 95% = 0.57-0.91); p = 0.96] nor the route of administration (injectable or oral) [RR = 0.75 (95% CI = 0.64-0.87) vs. RR = 0.74 (95% CI = 0.66-0.83); p = 0.92] had a differential effect on the risk of disability progression. Either considerable (5-20%) or significant (>20%) rates of loss to follow-up were reported in many study protocols, while financial and/or other support from pharmaceutical industries with a clear conflict of interest on the study outcomes was documented in all included studies.
conclusionsAvailable DMD are effective in reducing disability progression in patients with RRMS, independently of the route of administration and their classification as "first" or "second" line therapies. Attrition bias needs to be taken into account in the interpretation of these findings.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.