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Sphingosine-1-phosphate receptor modulators versus interferon beta for the treatment of relapsing–remitting multiple sclerosis: findings from randomized controlled trials

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Abstract

Background

As one kind of disease-modifying therapies, sphingosine-1-phosphate receptor (S1PR) modulators such as fingolimod, ozanimod, and siponimod have been approved or are being developed to treat multiple sclerosis (MS). Several randomized controlled trials (RCT) have been implemented to compare the efficacy and safety of S1PR modulators versus interferon beta in the treatment of people with relapsing–remitting multiple sclerosis (RRMS).

Method

We searched RCTs which were implemented from January 2010 to June 2020 by searching PubMed, Embase, Cochrane Library databases, and the Central Register of Controlled Trials. Finally, five RCTs were included in our study after carefully choosing.

Result

We pooled 4304 patients from 5 RCTs. The primary outcome was the annualized relapse rate. We found that the annualized relapse rate in the S1PR modulator group is 20% less than that in the interferon beta group (95%CI, − 0.32 to − 0.07, P = 0.002). S1PR modulators led to a significant reduction in number of new or enlarging T2 lesions per scan and number of gadolinium-enhancing lesions compared with interferon beta. Moreover, S1PR modulators can also improve 54-item multiple sclerosis quality of life (MSQOL-54) physical health composite score (P = 0.0005).

Conclusion

S1PR modulators exhibited good efficacy and safety for the treatment of RRMS compared with interferon beta. According to follow-up trials, S1PR modulators can improve MSQOL-54 physical health composite score so that it may be beneficial to neurological recovery which need more research to confirm.

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Data availability

The database supporting the conclusion of this article is included within the article and its additional files (fig file and table file).

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Acknowledgements

It is grateful to everyone who has taken part in the research.

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Author notes

  1. Siyuan Yang and Xiang Li contributed equally to this work.

Authors and Affiliations

  1. Department of Clinical Medicine, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China

    Siyuan Yang, Xiang Li, Jiahe Wang, Tianyi Wang, Zhongmou Xu & Gang Chen

  2. Department of Clinical Medicine, The Affiliated Jiangyin Hospital, School of Medicine, Southeast University, No. 3 yingrui road, Jiangyin, 214400, Jiangsu Province, China

    Heng Gao

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  1. Siyuan Yang
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Contributions

HG and GC were principal investigators. SYY and XL contributed to analyzing the statistical data. SYY, JHW, ZMX, and TYW were major contributors in the writing of the manuscript. XL and JHW revised the manuscript and polish the language.

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Correspondence to Heng Gao.

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Yang, S., Li, X., Wang, J. et al. Sphingosine-1-phosphate receptor modulators versus interferon beta for the treatment of relapsing–remitting multiple sclerosis: findings from randomized controlled trials. Neurol Sci 43, 3565–3581 (2022). https://doi.org/10.1007/s10072-022-05988-y

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