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- Title
Efficacy of Disease-Modifying Therapies in Relapsing Remitting Multiple Sclerosis: A Systematic Comparison.
- Authors
Freedman, Mark S.; Hughes, Bruce; Mikol, Daniel D.; Bennett, Randy; Cuffel, Brian; Divan, Vamil; LaVallee, Nicole; AL-Sabbagh, Ahmad
- Abstract
The treatment of relapsing-remitting multiple sclerosis (RRMS) has become more effective over the last decade with the advent of the currently available disease-modifying therapies (DMTs). Pivotal clinical studies differ in many characteristics, such that cross-comparisons of relative risk reductions are of limited value and can be misleading. Our objective was to compare the clinical efficacy of currently approved first-line DMTs in patients with RRMS, applying an evidence-based medicine approach. We reviewed all phase III pivotal trials of DMTs. Six clinical trials of Avonex®, Betaseron®, Copaxone®, Rebif® and Tysabri® in patients with RRMS were identified for analysis. Only randomized, placebo-controlled, double-blind studies were included. The clinical efficacy endpoints compared were: proportion of relapse-free patients at 1 and 2 years; annualized relapse rate at 2 years; proportion of progression-free patients at 2 years, and proportion of patients free of gadolinium-enhancing lesions at 1 year or 9 months. Based on these analyses, Betaseron, Rebif, and Tysabri show comparable effects, whereas for several endpoints Avonex or Copaxone did not significantly differ from placebo. In the absence of head-to-head studies for all products used to treat RRMS, it still may be possible to compare treatment effects by applying evidence-based medicine principles. Copyright © 2008 S. Karger AG, Basel
- Subjects
MULTIPLE sclerosis; THERAPEUTICS; EVIDENCE-based medicine; PLACEBOS; VIRUS diseases; MEDICAL research
- Publication
European Neurology, 2008, Vol 60, Issue 1, p1
- ISSN
0014-3022
- Publication type
Article
- DOI
10.1159/000127972