白细胞介素-6抑制剂治疗神经脊髓炎视网膜频谱紊乱症（NMOSD）：系统综述与荟萃分析。

IF 2.9 3区医学 Q2 CLINICAL NEUROLOGY

Multiple sclerosis and related disorders Pub Date : 2024-11-05 DOI:10.1016/j.msard.2024.106156

Giovani Noll , Marcos Madeira de Lima , Gabriel Paulo Mantovani , Felipe Gutierrez Pineda , Yasmin Picanço Silva , Pedro Guimarães Marcarini , Lucas Gabriel Mappes Reimao Reis , Viviana Regina Konzen , Alessandro Finkelsztejn

{"title":"白细胞介素-6抑制剂治疗神经脊髓炎视网膜频谱紊乱症（NMOSD）：系统综述与荟萃分析。","authors":"Giovani Noll , Marcos Madeira de Lima , Gabriel Paulo Mantovani , Felipe Gutierrez Pineda , Yasmin Picanço Silva , Pedro Guimarães Marcarini , Lucas Gabriel Mappes Reimao Reis , Viviana Regina Konzen , Alessandro Finkelsztejn","doi":"10.1016/j.msard.2024.106156","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Interleukin-6 (IL-6) inhibitors recently emerged as a promising therapy for neuromyelitis optica spectrum disorder (NMOSD).</div></div><div><h3>Objective</h3><div>We performed a systematic review and meta-analysis comparing IL-6 inhibitors to placebo or traditional immunosuppressants in NMOSD.</div></div><div><h3>Methods</h3><div>We searched PubMed, Embase, and Cochrane Central for eligible studies. Efficacy endpoints included hazard ratio (HR) for relapse, annualized relapse ratio (ARR) and Expanded Disability Status Scale (EDSS) change over time. Safety outcomes comprised any adverse event, serious adverse events and infections. Statistical analysis was performed using RevMan Web and R studio package meta. Heterogeneity was assessed with I² statistics.</div></div><div><h3>Results</h3><div>Four studies involving 361 patients (228 treated with IL-6 inhibitors) were included. IL-6 inhibitors significantly reduced HR for relapse (HR 0.35; 95 % CI 0.23, 0.55); p < 0.00001; I² = 0 %) and ARR (mean difference -0.79 relapses/year; 95 % CI -1.54, -0.03; p = 0.04; I² = 96 %) compared to placebo or traditional immunosuppressants. No significant differences were observed in EDSS change over 24 weeks of follow-up (mean difference -0.18; 95 % CI -0.41, 0.05; p = 0.93; I² = 0 %), adverse events (odds ratio (OR) 1.59; 95 % CI 0.45, 5.63; p = 0.48; I² = 48 %), serious adverse events (OR 0.76; 95 % CI 0.40, 1.44; p = 0.50; I² = 0 %) and infection rates (OR 1.10; 95 % CI 0.67, 1.79; p = 0.71; I² = 0 %).</div></div><div><h3>Conclusion</h3><div>IL-6 inhibitors demonstrate superior efficacy in preventing relapses in NMOSD compared to placebo or traditional immunosuppressants, without a notable increase in safety risks.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"92 ","pages":"Article 106156"},"PeriodicalIF":2.9000,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Interleukin-6 inhibitors for neuromyelitis optica spectrum disorder (NMOSD): A systematic review and meta-analysis\",\"authors\":\"Giovani Noll , Marcos Madeira de Lima , Gabriel Paulo Mantovani , Felipe Gutierrez Pineda , Yasmin Picanço Silva , Pedro Guimarães Marcarini , Lucas Gabriel Mappes Reimao Reis , Viviana Regina Konzen , Alessandro Finkelsztejn\",\"doi\":\"10.1016/j.msard.2024.106156\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Interleukin-6 (IL-6) inhibitors recently emerged as a promising therapy for neuromyelitis optica spectrum disorder (NMOSD).</div></div><div><h3>Objective</h3><div>We performed a systematic review and meta-analysis comparing IL-6 inhibitors to placebo or traditional immunosuppressants in NMOSD.</div></div><div><h3>Methods</h3><div>We searched PubMed, Embase, and Cochrane Central for eligible studies. Efficacy endpoints included hazard ratio (HR) for relapse, annualized relapse ratio (ARR) and Expanded Disability Status Scale (EDSS) change over time. Safety outcomes comprised any adverse event, serious adverse events and infections. Statistical analysis was performed using RevMan Web and R studio package meta. Heterogeneity was assessed with I² statistics.</div></div><div><h3>Results</h3><div>Four studies involving 361 patients (228 treated with IL-6 inhibitors) were included. IL-6 inhibitors significantly reduced HR for relapse (HR 0.35; 95 % CI 0.23, 0.55); p < 0.00001; I² = 0 %) and ARR (mean difference -0.79 relapses/year; 95 % CI -1.54, -0.03; p = 0.04; I² = 96 %) compared to placebo or traditional immunosuppressants. No significant differences were observed in EDSS change over 24 weeks of follow-up (mean difference -0.18; 95 % CI -0.41, 0.05; p = 0.93; I² = 0 %), adverse events (odds ratio (OR) 1.59; 95 % CI 0.45, 5.63; p = 0.48; I² = 48 %), serious adverse events (OR 0.76; 95 % CI 0.40, 1.44; p = 0.50; I² = 0 %) and infection rates (OR 1.10; 95 % CI 0.67, 1.79; p = 0.71; I² = 0 %).</div></div><div><h3>Conclusion</h3><div>IL-6 inhibitors demonstrate superior efficacy in preventing relapses in NMOSD compared to placebo or traditional immunosuppressants, without a notable increase in safety risks.</div></div>\",\"PeriodicalId\":18958,\"journal\":{\"name\":\"Multiple sclerosis and related disorders\",\"volume\":\"92 \",\"pages\":\"Article 106156\"},\"PeriodicalIF\":2.9000,\"publicationDate\":\"2024-11-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Multiple sclerosis and related disorders\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2211034824007326\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Multiple sclerosis and related disorders","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2211034824007326","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

摘要

背景：白细胞介素-6（IL-6）抑制剂最近成为治疗神经性脊髓炎视谱系障碍（NMOSD）的一种有前途的疗法：白细胞介素-6（IL-6）抑制剂最近成为治疗神经脊髓炎视网膜频谱障碍（NMOSD）的一种有前途的疗法：我们进行了一项系统综述和荟萃分析，比较了IL-6抑制剂与安慰剂或传统免疫抑制剂对NMOSD的治疗效果：方法：我们检索了PubMed、Embase和Cochrane Central的符合条件的研究。疗效终点包括复发危险比（HR）、年复发率（ARR）和扩展残疾状态量表（EDSS）随时间的变化。安全性结果包括任何不良事件、严重不良事件和感染。统计分析使用 RevMan Web 和 R studio 软件包 meta 进行。用I²统计量评估异质性：结果：共纳入了四项研究，涉及 361 名患者（228 人接受了 IL-6 抑制剂治疗）。与安慰剂或传统免疫抑制剂相比，IL-6抑制剂可明显降低复发HR（HR为0.35；95 % CI为0.23，0.55）；p < 0.00001；I² = 0 %）和ARR（平均差异为-0.79次复发/年；95 % CI为-1.54，-0.03；p = 0.04；I² = 96 %）。在随访 24 周的 EDSS 变化（平均差异 -0.18；95 % CI -0.41，0.05；p = 0.93；I² = 0 %）、不良事件（几率比（OR）1.59；95 % CI 0.45, 5.63; p = 0.48; I² = 48 %）、严重不良事件（OR 0.76; 95 % CI 0.40, 1.44; p = 0.50; I² = 0 %）和感染率（OR 1.10; 95 % CI 0.67, 1.79; p = 0.71; I² = 0 %）：结论：与安慰剂或传统免疫抑制剂相比，IL-6抑制剂在预防NMOSD复发方面显示出卓越的疗效，但安全风险并未显著增加。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Interleukin-6 inhibitors for neuromyelitis optica spectrum disorder (NMOSD): A systematic review and meta-analysis

Background

Interleukin-6 (IL-6) inhibitors recently emerged as a promising therapy for neuromyelitis optica spectrum disorder (NMOSD).

Objective

We performed a systematic review and meta-analysis comparing IL-6 inhibitors to placebo or traditional immunosuppressants in NMOSD.

Methods

We searched PubMed, Embase, and Cochrane Central for eligible studies. Efficacy endpoints included hazard ratio (HR) for relapse, annualized relapse ratio (ARR) and Expanded Disability Status Scale (EDSS) change over time. Safety outcomes comprised any adverse event, serious adverse events and infections. Statistical analysis was performed using RevMan Web and R studio package meta. Heterogeneity was assessed with I² statistics.

Results

Four studies involving 361 patients (228 treated with IL-6 inhibitors) were included. IL-6 inhibitors significantly reduced HR for relapse (HR 0.35; 95 % CI 0.23, 0.55); p < 0.00001; I² = 0 %) and ARR (mean difference -0.79 relapses/year; 95 % CI -1.54, -0.03; p = 0.04; I² = 96 %) compared to placebo or traditional immunosuppressants. No significant differences were observed in EDSS change over 24 weeks of follow-up (mean difference -0.18; 95 % CI -0.41, 0.05; p = 0.93; I² = 0 %), adverse events (odds ratio (OR) 1.59; 95 % CI 0.45, 5.63; p = 0.48; I² = 48 %), serious adverse events (OR 0.76; 95 % CI 0.40, 1.44; p = 0.50; I² = 0 %) and infection rates (OR 1.10; 95 % CI 0.67, 1.79; p = 0.71; I² = 0 %).

Conclusion

IL-6 inhibitors demonstrate superior efficacy in preventing relapses in NMOSD compared to placebo or traditional immunosuppressants, without a notable increase in safety risks.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Multiple sclerosis and related disorders CLINICAL NEUROLOGY-

CiteScore

5.80

自引率

20.00%

发文量

814

审稿时长

66 days

期刊介绍： Multiple Sclerosis is an area of ever expanding research and escalating publications. Multiple Sclerosis and Related Disorders is a wide ranging international journal supported by key researchers from all neuroscience domains that focus on MS and associated disease of the central nervous system. The primary aim of this new journal is the rapid publication of high quality original research in the field. Important secondary aims will be timely updates and editorials on important scientific and clinical care advances, controversies in the field, and invited opinion articles from current thought leaders on topical issues. One section of the journal will focus on teaching, written to enhance the practice of community and academic neurologists involved in the care of MS patients. Summaries of key articles written for a lay audience will be provided as an on-line resource. A team of four chief editors is supported by leading section editors who will commission and appraise original and review articles concerning: clinical neurology, neuroimaging, neuropathology, neuroepidemiology, therapeutics, genetics / transcriptomics, experimental models, neuroimmunology, biomarkers, neuropsychology, neurorehabilitation, measurement scales, teaching, neuroethics and lay communication.