Association of NEDA-4 With No Long-term Disability Progression in Multiple Sclerosis and Comparison With NEDA-3: A Systematic Review and Meta-analysis.


Journal

Neurology(R) neuroimmunology & neuroinflammation
ISSN: 2332-7812
Titre abrégé: Neurol Neuroimmunol Neuroinflamm
Pays: United States
ID NLM: 101636388

Informations de publication

Date de publication:
11 2022
Historique:
received: 22 03 2022
accepted: 02 08 2022
entrez: 12 10 2022
pubmed: 13 10 2022
medline: 15 10 2022
Statut: epublish

Résumé

No evidence of disease activity (NEDA)-4 has been suggested as a treatment target for disease-modifying therapy (DMT) in relapsing-remitting multiple sclerosis (RRMS). However, the ability of NEDA-4 to discriminate long-term outcomes in MS and how its performance compares with NEDA-3 remain uncertain. We conducted a systematic review and meta-analysis to evaluate (1) the association between NEDA-4 and no long-term disability progression in MS and (2) the comparative performance of NEDA-3 and NEDA-4 in predicting no long-term disability progression. English-language abstracts and manuscripts were systematically searched in MEDLINE, Embase, and the Cochrane databases from January 2006 to November 2021 and reviewed independently by 2 investigators. We selected studies that assessed NEDA-4 at 1 or 2 years after DMT start and had at least 4 years of follow-up for determination of no confirmed disability progression. We conducted a meta-analysis using random-effects model to determine the pooled odds ratio (OR) for no disability progression with NEDA-4 vs EDA-4. For the comparative analysis, we selected studies that evaluated both NEDA-3 and NEDA-4 with at least 4 years of follow-up and examined the difference in the association of NEDA-3 and NEDA-4 with no disability progression. Five studies of 1,000 patients (3 interferon beta and 2 fingolimod) met inclusion criteria for both objectives. The median duration of follow-up was 6 years (interquartile range: 4-6 years). The prevalence of NEDA-4 ranged from 4.2% to 13.9% on interferon beta therapy and 24.9% to 25.1% on fingolimod therapy. The pooled OR for no long-term confirmed disability progression with NEDA-4 vs EDA-4 was 2.14 (95% confidence interval: 1.36-3.37; I In patients with RRMS, NEDA-4 at 1-2 years was associated with 2 times higher odds of no long-term disability progression, at 6 years compared with EDA-4, but offered no advantage over NEDA-3.

Sections du résumé

BACKGROUND AND OBJECTIVES
No evidence of disease activity (NEDA)-4 has been suggested as a treatment target for disease-modifying therapy (DMT) in relapsing-remitting multiple sclerosis (RRMS). However, the ability of NEDA-4 to discriminate long-term outcomes in MS and how its performance compares with NEDA-3 remain uncertain. We conducted a systematic review and meta-analysis to evaluate (1) the association between NEDA-4 and no long-term disability progression in MS and (2) the comparative performance of NEDA-3 and NEDA-4 in predicting no long-term disability progression.
METHODS
English-language abstracts and manuscripts were systematically searched in MEDLINE, Embase, and the Cochrane databases from January 2006 to November 2021 and reviewed independently by 2 investigators. We selected studies that assessed NEDA-4 at 1 or 2 years after DMT start and had at least 4 years of follow-up for determination of no confirmed disability progression. We conducted a meta-analysis using random-effects model to determine the pooled odds ratio (OR) for no disability progression with NEDA-4 vs EDA-4. For the comparative analysis, we selected studies that evaluated both NEDA-3 and NEDA-4 with at least 4 years of follow-up and examined the difference in the association of NEDA-3 and NEDA-4 with no disability progression.
RESULTS
Five studies of 1,000 patients (3 interferon beta and 2 fingolimod) met inclusion criteria for both objectives. The median duration of follow-up was 6 years (interquartile range: 4-6 years). The prevalence of NEDA-4 ranged from 4.2% to 13.9% on interferon beta therapy and 24.9% to 25.1% on fingolimod therapy. The pooled OR for no long-term confirmed disability progression with NEDA-4 vs EDA-4 was 2.14 (95% confidence interval: 1.36-3.37; I
DISCUSSION
In patients with RRMS, NEDA-4 at 1-2 years was associated with 2 times higher odds of no long-term disability progression, at 6 years compared with EDA-4, but offered no advantage over NEDA-3.

Identifiants

pubmed: 36224046
pii: 9/6/e200032
doi: 10.1212/NXI.0000000000200032
pmc: PMC9558627
pii:
doi:

Substances chimiques

Interferon-beta 77238-31-4
Fingolimod Hydrochloride G926EC510T

Types de publication

Journal Article Meta-Analysis Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.

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Auteurs

Dalia Rotstein (D)

From the Department of Medicine, (D.R., A.M., G.S.), University of Toronto, Ontario, Canada; St. Michael's Hospital (D.R., A.M., G.S.), Toronto, Ontario, Canada; Department of Medicine, (J.M.S.), McMaster University, Hamilton, Ontario, Canada; Department of Health Sciences (M.P.S.), Section of Biostatistics, University of Genova, Italy; IRCCS Ospedale Policlinico San Martino (M.P.S.), Genova, Italy; Department of Neurology and Cemcat (X.M.), Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona; Department of Pediatrics (X.Y.Y., P.S.), Mount Sinai Hospital, Toronto, Canada; Columbia University Irving Medical Center (D.D.), Department of Neurology, New York City; York Presbyterian Hospital (NYP) (D.D.), New York City; and Institute of Health (P.S.), Policy, Management and Evaluation, University of Toronto, Canada. dalia.rotstein@unityhealth.to.

Jacqueline M Solomon (JM)

From the Department of Medicine, (D.R., A.M., G.S.), University of Toronto, Ontario, Canada; St. Michael's Hospital (D.R., A.M., G.S.), Toronto, Ontario, Canada; Department of Medicine, (J.M.S.), McMaster University, Hamilton, Ontario, Canada; Department of Health Sciences (M.P.S.), Section of Biostatistics, University of Genova, Italy; IRCCS Ospedale Policlinico San Martino (M.P.S.), Genova, Italy; Department of Neurology and Cemcat (X.M.), Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona; Department of Pediatrics (X.Y.Y., P.S.), Mount Sinai Hospital, Toronto, Canada; Columbia University Irving Medical Center (D.D.), Department of Neurology, New York City; York Presbyterian Hospital (NYP) (D.D.), New York City; and Institute of Health (P.S.), Policy, Management and Evaluation, University of Toronto, Canada.

Maria Pia Sormani (MP)

From the Department of Medicine, (D.R., A.M., G.S.), University of Toronto, Ontario, Canada; St. Michael's Hospital (D.R., A.M., G.S.), Toronto, Ontario, Canada; Department of Medicine, (J.M.S.), McMaster University, Hamilton, Ontario, Canada; Department of Health Sciences (M.P.S.), Section of Biostatistics, University of Genova, Italy; IRCCS Ospedale Policlinico San Martino (M.P.S.), Genova, Italy; Department of Neurology and Cemcat (X.M.), Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona; Department of Pediatrics (X.Y.Y., P.S.), Mount Sinai Hospital, Toronto, Canada; Columbia University Irving Medical Center (D.D.), Department of Neurology, New York City; York Presbyterian Hospital (NYP) (D.D.), New York City; and Institute of Health (P.S.), Policy, Management and Evaluation, University of Toronto, Canada.

Xavier Montalban (X)

From the Department of Medicine, (D.R., A.M., G.S.), University of Toronto, Ontario, Canada; St. Michael's Hospital (D.R., A.M., G.S.), Toronto, Ontario, Canada; Department of Medicine, (J.M.S.), McMaster University, Hamilton, Ontario, Canada; Department of Health Sciences (M.P.S.), Section of Biostatistics, University of Genova, Italy; IRCCS Ospedale Policlinico San Martino (M.P.S.), Genova, Italy; Department of Neurology and Cemcat (X.M.), Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona; Department of Pediatrics (X.Y.Y., P.S.), Mount Sinai Hospital, Toronto, Canada; Columbia University Irving Medical Center (D.D.), Department of Neurology, New York City; York Presbyterian Hospital (NYP) (D.D.), New York City; and Institute of Health (P.S.), Policy, Management and Evaluation, University of Toronto, Canada.

Xiang Y Ye (XY)

From the Department of Medicine, (D.R., A.M., G.S.), University of Toronto, Ontario, Canada; St. Michael's Hospital (D.R., A.M., G.S.), Toronto, Ontario, Canada; Department of Medicine, (J.M.S.), McMaster University, Hamilton, Ontario, Canada; Department of Health Sciences (M.P.S.), Section of Biostatistics, University of Genova, Italy; IRCCS Ospedale Policlinico San Martino (M.P.S.), Genova, Italy; Department of Neurology and Cemcat (X.M.), Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona; Department of Pediatrics (X.Y.Y., P.S.), Mount Sinai Hospital, Toronto, Canada; Columbia University Irving Medical Center (D.D.), Department of Neurology, New York City; York Presbyterian Hospital (NYP) (D.D.), New York City; and Institute of Health (P.S.), Policy, Management and Evaluation, University of Toronto, Canada.

Dina Dababneh (D)

From the Department of Medicine, (D.R., A.M., G.S.), University of Toronto, Ontario, Canada; St. Michael's Hospital (D.R., A.M., G.S.), Toronto, Ontario, Canada; Department of Medicine, (J.M.S.), McMaster University, Hamilton, Ontario, Canada; Department of Health Sciences (M.P.S.), Section of Biostatistics, University of Genova, Italy; IRCCS Ospedale Policlinico San Martino (M.P.S.), Genova, Italy; Department of Neurology and Cemcat (X.M.), Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona; Department of Pediatrics (X.Y.Y., P.S.), Mount Sinai Hospital, Toronto, Canada; Columbia University Irving Medical Center (D.D.), Department of Neurology, New York City; York Presbyterian Hospital (NYP) (D.D.), New York City; and Institute of Health (P.S.), Policy, Management and Evaluation, University of Toronto, Canada.

Alexandra Muccilli (A)

From the Department of Medicine, (D.R., A.M., G.S.), University of Toronto, Ontario, Canada; St. Michael's Hospital (D.R., A.M., G.S.), Toronto, Ontario, Canada; Department of Medicine, (J.M.S.), McMaster University, Hamilton, Ontario, Canada; Department of Health Sciences (M.P.S.), Section of Biostatistics, University of Genova, Italy; IRCCS Ospedale Policlinico San Martino (M.P.S.), Genova, Italy; Department of Neurology and Cemcat (X.M.), Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona; Department of Pediatrics (X.Y.Y., P.S.), Mount Sinai Hospital, Toronto, Canada; Columbia University Irving Medical Center (D.D.), Department of Neurology, New York City; York Presbyterian Hospital (NYP) (D.D.), New York City; and Institute of Health (P.S.), Policy, Management and Evaluation, University of Toronto, Canada.

Georges Saab (G)

From the Department of Medicine, (D.R., A.M., G.S.), University of Toronto, Ontario, Canada; St. Michael's Hospital (D.R., A.M., G.S.), Toronto, Ontario, Canada; Department of Medicine, (J.M.S.), McMaster University, Hamilton, Ontario, Canada; Department of Health Sciences (M.P.S.), Section of Biostatistics, University of Genova, Italy; IRCCS Ospedale Policlinico San Martino (M.P.S.), Genova, Italy; Department of Neurology and Cemcat (X.M.), Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona; Department of Pediatrics (X.Y.Y., P.S.), Mount Sinai Hospital, Toronto, Canada; Columbia University Irving Medical Center (D.D.), Department of Neurology, New York City; York Presbyterian Hospital (NYP) (D.D.), New York City; and Institute of Health (P.S.), Policy, Management and Evaluation, University of Toronto, Canada.

Prakesh Shah (P)

From the Department of Medicine, (D.R., A.M., G.S.), University of Toronto, Ontario, Canada; St. Michael's Hospital (D.R., A.M., G.S.), Toronto, Ontario, Canada; Department of Medicine, (J.M.S.), McMaster University, Hamilton, Ontario, Canada; Department of Health Sciences (M.P.S.), Section of Biostatistics, University of Genova, Italy; IRCCS Ospedale Policlinico San Martino (M.P.S.), Genova, Italy; Department of Neurology and Cemcat (X.M.), Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona; Department of Pediatrics (X.Y.Y., P.S.), Mount Sinai Hospital, Toronto, Canada; Columbia University Irving Medical Center (D.D.), Department of Neurology, New York City; York Presbyterian Hospital (NYP) (D.D.), New York City; and Institute of Health (P.S.), Policy, Management and Evaluation, University of Toronto, Canada.

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