Safety and Efficacy of Nusinersen and Risdiplam for Spinal Muscular Atrophy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Objective: We performed a systematic review and meta-analysis of the efficacy and safety of nusinersen and risdiplam in the treatment of spinal muscular disease (SMA). Methods: We screened the literature published in Pubmed, Web of Science, Embase, and Cochrane before July 2023 to conduct randomized...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-10-01
|
| Series: | Brain Sciences |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2076-3425/13/10/1419 |
| _version_ | 1797574519670439936 |
|---|---|
| author | Yue Qiao Yuewei Chi Jian Gu Ying Ma |
| author_facet | Yue Qiao Yuewei Chi Jian Gu Ying Ma |
| author_sort | Yue Qiao |
| collection | DOAJ |
| description | Objective: We performed a systematic review and meta-analysis of the efficacy and safety of nusinersen and risdiplam in the treatment of spinal muscular disease (SMA). Methods: We screened the literature published in Pubmed, Web of Science, Embase, and Cochrane before July 2023 to conduct randomized controlled trials to test the treatment of SMA patients with nusinersen and risdiplam. The data were analyzed using Review Manager 5.4 software and Stata version 15.0 software. Results: A total of six randomized controlled trials were included, involving 728 SMA patients, to synthesize evidence. It is reported that nusinersen treatment was beneficial for increasing the score of the Hammersmith Functional Motor Scale—Expanded (HFMSE) (WMD: 4.90; 95% CI: 3.17, 6.63; <i>p</i> < 0.00001), Revised Upper Limb Module (RULM) (WMD: 3.70; 95% CI: 3.30, 4.10; <i>p</i> < 0.00001), and Hammersmith Infant Neurological Evaluation Section 2 (HINE-2) (WMD: 5.21; 95% CI: 4.83, 5.60; <i>p</i> < 0.00001). In addition, the risdiplam treatment group also showed statistically significant improvements in the HFMSE score (WMD:0.87; 95% CI: 0.05, 1.68; <i>p</i> = 0.04), the 32-item Motor Function Measure (MFM32) (WMD:1.48; 95% CI: 0.58, 2.38; <i>p</i> = 0.001), and (WMD: 1.29; 95% CI: 0.57, 2.01; <i>p</i> = 0.0005). Nusinersen and risdiplam did not cause a statistically significant increase in the RULM score for adverse events (OR: 0.93; 95% CI: 0.51, 1.7; <i>p</i> = 0.82) and for severe adverse events (OR: 0.77; 95% CI: 0.47, 1.27; <i>p</i> = 0.31). Conclusion: Our analysis found that nusinersen and risdiplam treatment showed clinically meaningful improvement in motor function and a similar incidence rate of adverse events compared with the placebo. Further research should be carried out to provide a direct comparison between the two drugs in terms of safety and efficacy. |
| first_indexed | 2024-03-10T21:23:37Z |
| format | Article |
| id | doaj.art-87f74cdb33f44e84aeaf6ec8ff3cdd91 |
| institution | Directory Open Access Journal |
| issn | 2076-3425 |
| language | English |
| last_indexed | 2024-03-10T21:23:37Z |
| publishDate | 2023-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Brain Sciences |
| spelling | doaj.art-87f74cdb33f44e84aeaf6ec8ff3cdd912023-11-19T15:52:40ZengMDPI AGBrain Sciences2076-34252023-10-011310141910.3390/brainsci13101419Safety and Efficacy of Nusinersen and Risdiplam for Spinal Muscular Atrophy: A Systematic Review and Meta-Analysis of Randomized Controlled TrialsYue Qiao0Yuewei Chi1Jian Gu2Ying Ma3Department of Neurology, Shengjing Hospital of China Medical University, Shenyang 110055, ChinaDepartment of Neurology, Shengjing Hospital of China Medical University, Shenyang 110055, ChinaDepartment of Neurology, Shengjing Hospital of China Medical University, Shenyang 110055, ChinaDepartment of Neurology, Shengjing Hospital of China Medical University, Shenyang 110055, ChinaObjective: We performed a systematic review and meta-analysis of the efficacy and safety of nusinersen and risdiplam in the treatment of spinal muscular disease (SMA). Methods: We screened the literature published in Pubmed, Web of Science, Embase, and Cochrane before July 2023 to conduct randomized controlled trials to test the treatment of SMA patients with nusinersen and risdiplam. The data were analyzed using Review Manager 5.4 software and Stata version 15.0 software. Results: A total of six randomized controlled trials were included, involving 728 SMA patients, to synthesize evidence. It is reported that nusinersen treatment was beneficial for increasing the score of the Hammersmith Functional Motor Scale—Expanded (HFMSE) (WMD: 4.90; 95% CI: 3.17, 6.63; <i>p</i> < 0.00001), Revised Upper Limb Module (RULM) (WMD: 3.70; 95% CI: 3.30, 4.10; <i>p</i> < 0.00001), and Hammersmith Infant Neurological Evaluation Section 2 (HINE-2) (WMD: 5.21; 95% CI: 4.83, 5.60; <i>p</i> < 0.00001). In addition, the risdiplam treatment group also showed statistically significant improvements in the HFMSE score (WMD:0.87; 95% CI: 0.05, 1.68; <i>p</i> = 0.04), the 32-item Motor Function Measure (MFM32) (WMD:1.48; 95% CI: 0.58, 2.38; <i>p</i> = 0.001), and (WMD: 1.29; 95% CI: 0.57, 2.01; <i>p</i> = 0.0005). Nusinersen and risdiplam did not cause a statistically significant increase in the RULM score for adverse events (OR: 0.93; 95% CI: 0.51, 1.7; <i>p</i> = 0.82) and for severe adverse events (OR: 0.77; 95% CI: 0.47, 1.27; <i>p</i> = 0.31). Conclusion: Our analysis found that nusinersen and risdiplam treatment showed clinically meaningful improvement in motor function and a similar incidence rate of adverse events compared with the placebo. Further research should be carried out to provide a direct comparison between the two drugs in terms of safety and efficacy.https://www.mdpi.com/2076-3425/13/10/1419spinal muscular atrophynusinersenrisdiplammeta-analysisefficacysafety |
| spellingShingle | Yue Qiao Yuewei Chi Jian Gu Ying Ma Safety and Efficacy of Nusinersen and Risdiplam for Spinal Muscular Atrophy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials Brain Sciences spinal muscular atrophy nusinersen risdiplam meta-analysis efficacy safety |
| title | Safety and Efficacy of Nusinersen and Risdiplam for Spinal Muscular Atrophy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials |
| title_full | Safety and Efficacy of Nusinersen and Risdiplam for Spinal Muscular Atrophy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials |
| title_fullStr | Safety and Efficacy of Nusinersen and Risdiplam for Spinal Muscular Atrophy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials |
| title_full_unstemmed | Safety and Efficacy of Nusinersen and Risdiplam for Spinal Muscular Atrophy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials |
| title_short | Safety and Efficacy of Nusinersen and Risdiplam for Spinal Muscular Atrophy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials |
| title_sort | safety and efficacy of nusinersen and risdiplam for spinal muscular atrophy a systematic review and meta analysis of randomized controlled trials |
| topic | spinal muscular atrophy nusinersen risdiplam meta-analysis efficacy safety |
| url | https://www.mdpi.com/2076-3425/13/10/1419 |
| work_keys_str_mv | AT yueqiao safetyandefficacyofnusinersenandrisdiplamforspinalmuscularatrophyasystematicreviewandmetaanalysisofrandomizedcontrolledtrials AT yueweichi safetyandefficacyofnusinersenandrisdiplamforspinalmuscularatrophyasystematicreviewandmetaanalysisofrandomizedcontrolledtrials AT jiangu safetyandefficacyofnusinersenandrisdiplamforspinalmuscularatrophyasystematicreviewandmetaanalysisofrandomizedcontrolledtrials AT yingma safetyandefficacyofnusinersenandrisdiplamforspinalmuscularatrophyasystematicreviewandmetaanalysisofrandomizedcontrolledtrials |