LI Fengyun,LAN Rui,ZHAO Duo,et al.Efficacy and safety of dimethyl fumarate in the treatment of multiple sclerosis:a meta-analysis[J].ZHONGGUO YAOFANG,2024,35(14):1776-1780.
LI Fengyun,LAN Rui,ZHAO Duo,et al.Efficacy and safety of dimethyl fumarate in the treatment of multiple sclerosis:a meta-analysis[J].ZHONGGUO YAOFANG,2024,35(14):1776-1780. DOI: 10.6039/j.issn.1001-0408.2024.14.18.
Efficacy and safety of dimethyl fumarate in the treatment of multiple sclerosis:a meta-analysis
To evaluate the efficacy and safety of dimethyl fumarate (DMF) in the treatment of multiple sclerosis (MS).
METHODS
2
Retrieved from CBM, Web of Science, PubMed, the Cochrane Library, Embase, CNKI, Wanfang Data, and VIP, randomized controlled trials (RCTs) about DMF (trial group) versus other drugs or placebo (control group) were collected. After data screening and extraction, quality evaluation, meta-analysis was conducted by using RevMan 5.3 software.
RESULTS
2
A total of 6 literature were included, involving 638 patients. Results of meta-analysis showed that the proportion of patients with lesion changes after treatment in the trial group was lower than control group [MD=-0.65, 95%CI(-1.27, -0.02),
P
=0.04
]
; there was no statistical significance in recurrence rate [RR=1.06, 95%CI(0.52,2.17),
P
=0.88
]
, the proportion of patients with new lesions after treatment [RR=1.05, 95%CI(0.62,1.80),
P
=0.85
]
, expanded disability status scale after treatment [MD=0.02,95%CI (-0.18, 0.23),
P
=0.82
]
, the incidence of adverse events [RR=1.33, 95%CI(0.97, 1.84),
P
=0.08
]
or severe adverse events [RR=0.95,95%CI(0.48,1.90),
P
=0.89
]
between 2 groups. Results of sensitivity analysis showed the study obtained unstable recurrence rate and the incidence of adverse events, while other results were robust.
CONCLUSIONS
2
DMF can control the lesion progression in MS patients to some extent and doesn’t increase the incidence of adverse events and serious adverse events, but there is no significant advantage in reducing the recurrence rate and controlling the disability progression.
Neuroimmunology Division of Chinese Society for Immunology , Neuroimmunology Group of Neurology Division of Chinese Medical Association . Chinese consensus on diagnosis and treatment on multiple slcerosis:2018 version [J ] . Chin J Neuroimmunol Neurol , 2018 , 25 ( 6 ): 387 - 394 .
CALLEGARI I , DERFUSS T , GALLI E . Update on treatment in multiple sclerosis [J ] . Presse Med , 2021 , 50 ( 2 ): 104068 .
ZHONG X N , HU X Q . Interpretation of Chinese expert Consensus on Diagnosis and Treatment of Multiple Sclerosis:2018 Edition [J ] . Chin J Neuroimmunol Neurol , 2019 , 26 ( 2 ): 80 - 83 .
WEI S F , ZHAO Z G . Drug treatment and pharmaceutical care of multiple sclerosis [J ] . Her Med , 2023 , 42 ( 5 ): 742 - 749 .
YAMOUT B , SAHRAIAN M , BOHLEGA S , et al . Consensus recommendations for the diagnosis and treatment of multiple sclerosis:2019 revisions to the MENACTRIMS guidelines [J ] . Mult Scler Relat Disord , 2020 , 37 : 101459 .
WANG L Q , ZHU F , XUE Q , et al . Clinical application status of disease-modifying therapy drug for multiple sclerosis [J ] . Clin Med J , 2023 , 21 ( 10 ): 6 - 11 .
TAN H M , QUAN C . Interpretation of multiple sclerosis therapy consensus group:position statement on disease-modifying therapies for multiple sclerosis:white paper [J ] . Chin J Clin Neurosci , 2023 , 31 ( 5 ): 547 - 549,557 .
RUI M J , DU X W , XIE L , et al . Cost-utility analysis of dimethyl fumarate compared with terifunomide for the treatment of relapsing multiple sclerosis in China [J ] . World Clin Drug , 2022 , 43 ( 11 ): 1475 - 1485 .
LI W , SUN Y Z , FANG J , et al . Cost-minimization analysis of dimethyl fumarate in the treatment of relapsing multiple sclerosis [J ] . China Pharm , 2022 , 33 ( 24 ): 3005 - 3009 .
HIGGINS J P T , ALTMAN D G , GØTZSCHE P C , et al . The Cochrane collaboration’s tool for assessing risk of bias in randomised trials [J ] . BMJ , 2011 , 343 : d5928 .
OCHI H , NIINO M , ONIZUKA Y , et al . 72-week safety and tolerability of dimethyl fumarate in Japanese patients with relapsing-remitting multiple sclerosis:analysis of the randomised,double blind,placebo-controlled,phase Ⅲ APEX study and its open-label extension [J ] . Adv Ther , 2018 , 35 ( 10 ): 1598 - 1611 .
MASJEDI S S , ETEMADIFAR M , ZADEH N M , et al . Assessment of fingolimod versus dimethyl fumarate for the treatment of multiple sclerosis;a 24-month follow-up study [J ] . Am J Clin Exp Immunol , 2021 , 10 ( 3 ): 86 - 92 .
HØJSGAARD CHOW H , TALBOT J , LUNDELL H , et al . Dimethyl fumarate treatment in patients with primary progressive multiple sclerosis:a randomized,controlled trial [J ] . Neurol Neuroimmunol Neuroinflamm , 2021 , 8 ( 5 ): e1037 .
VERMERSCH P , SCARAMOZZA M , LEVIN S , et al . Effect of dimethyl fumarate vs interferon β-1a in patients with pediatric-onset multiple sclerosis:the CONNECT randomized clinical trial [J ] . JAMA Netw Open , 2022 , 5 ( 9 ): e2230439 .
SVENNINGSSON A , FRISELL T , BURMAN J , et al . Safety and efficacy of rituximab versus dimethyl fumarate in patients with relapsing-remitting multiple sclerosis or clinically isolated syndrome in Sweden:a rater-blinded,phase 3,randomised controlled trial [J ] . Lancet Neurol , 2022 , 21 ( 8 ): 693 - 703 .
MACMANUS D G , MILLER D H , KAPPOS L , et al . BG-12 reduces evolution of new enhancing lesions to T1-hypointense lesions in patients with multiple sclerosis [J ] . J Neurol , 2011 , 258 ( 3 ): 449 - 456 .
BLAIR H A . Dimethyl fumarate:a review in relapsing-remitting MS [J ] . Drugs , 2019 , 79 ( 18 ): 1965 - 1976 .
Neuroimmunology Group of Neurology Society of Chinese Medical Association . Chinese guidelines for diagnosis and treatment of multiple sclerosis:2023 edition [J ] . Chin J Neurol , 2024 , 57 ( 1 ): 10 - 23 .
QIAO B Y . Analysis of clinical characteristics and prognostic factors of 51 patients with multiple sclerosis in Suzhou area [D ] . Suzhou : Soochow University , 2022 .
MAJKUTEWICZ I . Dimethyl fumarate:a review of preclinical efficacy in models of neurodegenerative diseases [J ] . Eur J Pharmacol , 2022 , 926 : 175025 .
HOSSEINI A , MASJEDI A , BARADARAN B , et al . Dimethyl fumarate:regulatory effects on the immune system in the treatment of multiple sclerosis [J ] . J Cell Physiol , 2019 , 234 ( 7 ): 9943 - 9955 .
VOLLMER B L , NAIR K , SILLAU S , et al . Rituximab versus natalizumab,fingolimod,and dimethyl fumarate in multiple sclerosis treatment [J ] . Ann Clin Transl Neurol , 2020 , 7 ( 9 ): 1466 - 1476 .
PROSPERINI L , HAGGIAG S , RUGGIERI S , et al . Dimethyl fumarate or teriflunomide for relapsing-remitting multiple sclerosis:a meta-analysis of post-marketing stu-dies [J ] . Neurotherapeutics , 2023 , 20 ( 5 ): 1275 - 1283 .
LIANG G , CHAI J L , NG H S , et al . Safety of dimethyl fumarate for multiple sclerosis:a systematic review and meta-analysis [J ] . Mult Scler Relat Disord , 2020 , 46 : 102566 .
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