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A meta-analysis comparing first-line immunosuppressants in neuromyelitis optica

dc.rights.licenseopenen_US
dc.contributor.authorGIOVANNELLI, J.
dc.contributor.authorCIRON, J.
dc.contributor.authorCOHEN, M.
dc.contributor.authorKIM, H.-J.
dc.contributor.authorKIM, S.-H.
dc.contributor.authorSTELLMANN, J.-P.
dc.contributor.authorKLEITER, I.
dc.contributor.authorMCCREARY, M.
dc.contributor.authorGREENBERG, B.M.
dc.contributor.authorDESCHAMPS, R.
dc.contributor.authorAUDOIN, B.
dc.contributor.authorMAILLART, E.
dc.contributor.authorPAPEIX, C.
dc.contributor.authorCOLLONGUES, N.
dc.contributor.authorBOURRE, B.
dc.contributor.authorLAPLAUD, D.
dc.contributor.authorAYRIGNAC, X.
dc.contributor.authorDURAND-DUBIEF, F.
hal.structure.identifierNeurocentre Magendie : Physiopathologie de la Plasticité Neuronale [U1215 Inserm - UB]
dc.contributor.authorRUET, Aurelie
dc.contributor.authorVUKUSIC, S.
dc.contributor.authorMARIGNIER, R.
dc.contributor.authorDAUCHET, L.
dc.contributor.authorZEPHIR, H.
dc.date.accessioned2022-03-29T16:07:03Z
dc.date.available2022-03-29T16:07:03Z
dc.date.issued2021-10
dc.identifier.issn2328-9503en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/136554
dc.description.abstractEnObjective : As phase III trials have shown interest in innovative but expensive drugs in the treatment of neuromyelitis optica spectrum disorder (NMOSD), data are needed to clarify strategies in the treatment of neuromyelitis optica (NMO). This meta-analysis compares the efficacy of first-line strategies using rituximab (RTX), mycophenolate mofetil (MMF), or azathioprine (AZA), which are still widely used. Methods : Studies identified by the systematic review of Huang et al. (2019) were selected if they considered at least two first-line immunosuppressants among RTX, MMF, and AZA. We updated this review. The Medline, Cochrane Central Register of Controlled Trials, Embase, and ClinicalTrials databases were queried between November 2018 and April 2020. To be included, the hazard ratio (HR) [95% CI] for the time to first relapse after first-line immunosuppression had to be available, calculable, or provided by the authors. Results : We gathered data from 919 NMO patients (232 RTX-, 294 MMF-, and 393 AZA-treated patients). The risk of first relapse after first-line immunosuppression was 1.55 [1.04, 2.31] (p = 0.03) for MMF compared with RTX, 1.42 [0.87, 2.30] (p = 0.16) for AZA compared with RTX, and 0.94 [0.58, 1.54] (p = 0.08) for MMF compared with AZA. Interpretation : The findings suggest that RTX is more efficient than MMF as a first-line therapy. Even if the results of our meta-analysis cannot conclude that RTX has a better efficacy in delaying the first relapse than AZA, the observed effect difference between both treatments combined with the results of previous studies using as outcome the annualized relapse rate may be in favor of RTX.
dc.language.isoENen_US
dc.rightsAttribution-NonCommercial-NoDerivs 3.0 United States*
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/3.0/us/*
dc.title.enA meta-analysis comparing first-line immunosuppressants in neuromyelitis optica
dc.title.alternativeAnn Clin Transl Neurolen_US
dc.typeArticle de revueen_US
dc.identifier.doi10.1002/acn3.51451en_US
dc.subject.halSciences du Vivant [q-bio]/Neurosciences [q-bio.NC]en_US
dc.identifier.pubmed34505407en_US
bordeaux.journalAnnals of Clinical and Translational Neurologyen_US
bordeaux.page2025-2037en_US
bordeaux.volume8en_US
bordeaux.hal.laboratoriesNeurocentre Magendie - UMR-S 1215en_US
bordeaux.issue10en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.institutionINSERMen_US
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
hal.identifierhal-03623634
hal.version1
hal.date.transferred2022-03-29T16:07:06Z
hal.exporttrue
dc.rights.ccCC BY-NC-NDen_US
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