SynthesisFrontiers in oncology2026
Comparative efficacy and safety of pharmacological treatments for lower-risk myelodysplastic syndromes: a Systematic Review and network meta-analysis.
Synthesis in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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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.
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Authors and funding
5 authors.
Funding
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Abstract
Background: The comparative efficacy of pharmacological treatments for lower-risk myelodysplastic syndromes (LR-MDS) remains uncertain because head-to-head randomised evidence is limited. Methods: We performed a systematic review and network meta-analysis of randomised controlled trials evaluating pharmacological treatments for LR-MDS. Outcomes of interest were haematological improvement-erythroid (HI-E), red blood cell transfusion independence (RBC-TI), haematological improvement-platelet (HI-P), and adverse events (AEs). Results: We included 20 trials (2,877 participants), of which 17 trials (2,670 participants) contributed to connected treatment networks. For HI-E, luspatercept and ESA-based regimens were associated with higher rates. Lenalidomide-containing regimens showed favourable RBC-TI outcomes, including lenalidomide plus ESA, lenalidomide with or without ESA and/or G-CSF, and lenalidomide monotherapy. For HI-P, eltrombopag and romiplostim showed potential benefits. Safety profiles differed across treatments: CC-486 and imetelstat were associated with higher odds of neutropenia and gastrointestinal toxicity, whereas luspatercept was associated with increased fatigue and AEs. Conclusion: Comparative treatment benefit in LR-MDS differs by clinical endpoint. These findings support an individualised, goal-directed treatment approach rather than a single universally superior therapy. Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD420251184384.
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