Evidence map›Paper›PMID 30285675›Full record

SynthesisBMC neurology2018

Comparative effectiveness of beta-interferons and glatiramer acetate for relapsing-remitting multiple sclerosis: systematic review and network meta-analysis of trials including recommended dosages.

G J Melendez-Torres, Xavier Armoiry, Rachel Court, Jacoby Patterson, Alan Kan, Peter Auguste, Jason Madan, Carl Counsell, Olga Ciccarelli, Aileen Clarke

Open access · goldAbstract readSystematic ReviewNetwork Meta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC neurology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 1 pooled it
3.8field-weighted citation impact, top 6% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 1 synthesis or guideline pooled it, 36 citations in OpenAlex.

  1. MS Fatigue Post High-Efficacy Treatment.European journal of neurology · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 1 country.

G J Melendez-TorresWarwick Evidence, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK. g.melendez-torres@warwick.ac.uk.ORCID http://orcid.org/0000-0002-9823-4790
Xavier ArmoiryWarwick Evidence, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK.
Rachel CourtWarwick Evidence, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK.
Jacoby PattersonIndependent research consultant, Windsor, UK.
Alan KanWarwick Evidence, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK.
Peter AugusteWarwick Evidence, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK.
Jason MadanWarwick Evidence, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK.
Carl CounsellInstitute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK.
Olga CiccarelliQueen Square Multiple Sclerosis Centre, University College London Institute of Neurology, London, UK.
Aileen ClarkeWarwick Evidence, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK.
University of Warwick · GBNational Institute for Health Research · GBUniversity of Aberdeen · GB

Funding

Health Technology Assessment Programme ID809
6 · The paper itself

Abstract

backgroundWe systematically reviewed the comparative effectiveness of injectable beta-interferons (IFN-β) and glatiramer acetate (GA) on annualised relapse rate (ARR), progression and discontinuation due to adverse events (AEs) in RRMS, using evidence from within the drugs' recommended dosages.

methodsWe updated prior comprehensive reviews, checked references of included studies, contacted experts in the field, and screened websites for relevant publications to locate randomised trials of IFN-β and GA with recommended dosages in RRMS populations, compared against placebo or other recommended dosages. Abstracts were screened and assessed for inclusion in duplicate and independently. Studies were appraised using the Cochrane risk of bias tool. Rate ratios for ARR, hazard ratios for time to progression, and risk ratios for discontinuation due to AEs were synthesised in separate models using random effects network meta-analysis.

resultsWe identified 24 studies reported in 42 publications. Most studies were at high risk of bias in at least one domain. All drugs had a beneficial effect on ARR as compared to placebo, but not compared to each other, and findings were robust to sensitivity analysis. We considered time to progression confirmed at 3 months and confirmed at 6 months in separate models; while both models suggested that the included drugs were effective, findings were not consistent between models. Discontinuation due to AEs did not appear to be different between drugs.

conclusionsMeta-analyses confirmed that IFN-β and GA reduce ARR and generally delay progression as defined in these trials, though there was no clear 'winner' across outcomes. Findings are additionally tempered by the high risk of bias across studies, and the use of an impairment/mobility scale to measure disease progression. Future research should consider more relevant measures of disability and, given that most trials have been short-term, consider a longitudinal approach to comparative effectiveness. REVIEW REGISTRATION: PROSPERO CRD42016043278 .

Indexed as

Disease ProgressionGlatiramer AcetateHumansImmunosuppressive AgentsInterferon-betaMultiple Sclerosis, Relapsing-RemittingGlatiramer AcetateImmunosuppressive AgentsInterferon-betaBeta-interferonClinically isolated syndromeEconomic evaluationGlatiramer acetateMultiple sclerosisSystematic review

Identifiers

PMID30285675
PMCPMC6169084
OpenAlexW2895296428

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.