Efficacy and safety of immunosuppressive therapy in myelin oligodendrocyte glycoprotein antibody–associated disease: a systematic review and meta-analysis

Background: A considerable number of patients with myelin oligodendrocyte glycoprotein antibody–associated disease (MOGAD) will experience a relapse, but the effect of maintenance therapies on re-attack rates is currently unknown. Objective: To investigate the efficacy and safety of immunosuppressiv...

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Autores principales:	Qi-Lun Lai, Yin-Xi Zhang, Meng-Ting Cai, Yang Zheng, Song Qiao, Gao-Li Fang, Chun-Hong Shen
Formato:	article
Lenguaje:	EN
Publicado:	SAGE Publishing 2021
Materias:	Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/4673307f7a234bfa90ef9addc29e47c1
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spelling	oai:doaj.org-article:4673307f7a234bfa90ef9addc29e47c12021-11-11T23:03:25ZEfficacy and safety of immunosuppressive therapy in myelin oligodendrocyte glycoprotein antibody–associated disease: a systematic review and meta-analysis1756-286410.1177/17562864211054157https://doaj.org/article/4673307f7a234bfa90ef9addc29e47c12021-11-01T00:00:00Zhttps://doi.org/10.1177/17562864211054157https://doaj.org/toc/1756-2864Background: A considerable number of patients with myelin oligodendrocyte glycoprotein antibody–associated disease (MOGAD) will experience a relapse, but the effect of maintenance therapies on re-attack rates is currently unknown. Objective: To investigate the efficacy and safety of immunosuppressive therapy for preventing disease relapses in patients with MOGAD, including rituximab (RTX), mycophenolate mofetil (MMF), and azathioprine (AZA). Methods: English-language studies published prior to August 31, 2020, were searched in the NCBI (PubMed), ISI Web of Science, and the Cochrane Library databases. Patient characteristics, treatment regimens, outcome measures, and adverse effects were retrieved. Results: We enrolled 11 studies in the final meta-analysis, including 346 patients with MOGAD. RTX therapy was demonstrated to result in reduced mean annualized relapse rate (ARR) by 1.35 (95% confidence interval (CI): 0.85–1.85) and reduced mean Expanded Disability Status Scale score by 0.80 (95% CI: 0.53–1.08) in patients with MOGAD. MMF therapy was associated with the mean ARR decreasing by 0.83 (95% CI: 0.31–1.35), and AZA was related to the mean ARR decreasing by 1.71 (95% CI: 0.83–2.58). The reported discontinuation rates of RTX, MMF, and AZA therapy due to adverse effects were 3/197 (1.52%), 3/39 (7.69%), and 4/37 (10.81%), respectively. Conclusion: The study provided evidence to support the efficacy of RTX, MMF, and AZA on the preventive treatment in patients with MOGAD. However, large randomized controlled trials are still needed in the future.Qi-Lun LaiYin-Xi ZhangMeng-Ting CaiYang ZhengSong QiaoGao-Li FangChun-Hong ShenSAGE PublishingarticleNeurology. Diseases of the nervous systemRC346-429ENTherapeutic Advances in Neurological Disorders, Vol 14 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Neurology. Diseases of the nervous system RC346-429
spellingShingle	Neurology. Diseases of the nervous system RC346-429 Qi-Lun Lai Yin-Xi Zhang Meng-Ting Cai Yang Zheng Song Qiao Gao-Li Fang Chun-Hong Shen Efficacy and safety of immunosuppressive therapy in myelin oligodendrocyte glycoprotein antibody–associated disease: a systematic review and meta-analysis
description	Background: A considerable number of patients with myelin oligodendrocyte glycoprotein antibody–associated disease (MOGAD) will experience a relapse, but the effect of maintenance therapies on re-attack rates is currently unknown. Objective: To investigate the efficacy and safety of immunosuppressive therapy for preventing disease relapses in patients with MOGAD, including rituximab (RTX), mycophenolate mofetil (MMF), and azathioprine (AZA). Methods: English-language studies published prior to August 31, 2020, were searched in the NCBI (PubMed), ISI Web of Science, and the Cochrane Library databases. Patient characteristics, treatment regimens, outcome measures, and adverse effects were retrieved. Results: We enrolled 11 studies in the final meta-analysis, including 346 patients with MOGAD. RTX therapy was demonstrated to result in reduced mean annualized relapse rate (ARR) by 1.35 (95% confidence interval (CI): 0.85–1.85) and reduced mean Expanded Disability Status Scale score by 0.80 (95% CI: 0.53–1.08) in patients with MOGAD. MMF therapy was associated with the mean ARR decreasing by 0.83 (95% CI: 0.31–1.35), and AZA was related to the mean ARR decreasing by 1.71 (95% CI: 0.83–2.58). The reported discontinuation rates of RTX, MMF, and AZA therapy due to adverse effects were 3/197 (1.52%), 3/39 (7.69%), and 4/37 (10.81%), respectively. Conclusion: The study provided evidence to support the efficacy of RTX, MMF, and AZA on the preventive treatment in patients with MOGAD. However, large randomized controlled trials are still needed in the future.
format	article
author	Qi-Lun Lai Yin-Xi Zhang Meng-Ting Cai Yang Zheng Song Qiao Gao-Li Fang Chun-Hong Shen
author_facet	Qi-Lun Lai Yin-Xi Zhang Meng-Ting Cai Yang Zheng Song Qiao Gao-Li Fang Chun-Hong Shen
author_sort	Qi-Lun Lai
title	Efficacy and safety of immunosuppressive therapy in myelin oligodendrocyte glycoprotein antibody–associated disease: a systematic review and meta-analysis
title_short	Efficacy and safety of immunosuppressive therapy in myelin oligodendrocyte glycoprotein antibody–associated disease: a systematic review and meta-analysis
title_full	Efficacy and safety of immunosuppressive therapy in myelin oligodendrocyte glycoprotein antibody–associated disease: a systematic review and meta-analysis
title_fullStr	Efficacy and safety of immunosuppressive therapy in myelin oligodendrocyte glycoprotein antibody–associated disease: a systematic review and meta-analysis
title_full_unstemmed	Efficacy and safety of immunosuppressive therapy in myelin oligodendrocyte glycoprotein antibody–associated disease: a systematic review and meta-analysis
title_sort	efficacy and safety of immunosuppressive therapy in myelin oligodendrocyte glycoprotein antibody–associated disease: a systematic review and meta-analysis
publisher	SAGE Publishing
publishDate	2021
url	https://doaj.org/article/4673307f7a234bfa90ef9addc29e47c1
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Efficacy and safety of immunosuppressive therapy in myelin oligodendrocyte glycoprotein antibody–associated disease: a systematic review and meta-analysis

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