Aging and efficacy of disease-modifying therapies in multiple sclerosis: a meta-analysis of clinical trials
Background: Disease-modifying therapies (DMTs) for multiple sclerosis (MS) are approved for the treatment of disease activity and are effective in reducing relapses and new magnetic resonance imaging (MRI) lesions. However, disease activity generally subsides with time, and age-dependent changes in...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2020-10-01
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| Series: | Therapeutic Advances in Neurological Disorders |
| Online Access: | https://doi.org/10.1177/1756286420969016 |
| _version_ | 1818774995044663296 |
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| author | Yinan Zhang Natalia Gonzalez Caldito Afsaneh Shirani Amber Salter Gary Cutter William Culpepper Mitchell Wallin Peter Kosa Bibiana Bielekova Fred Lublin Olaf Stuve |
| author_facet | Yinan Zhang Natalia Gonzalez Caldito Afsaneh Shirani Amber Salter Gary Cutter William Culpepper Mitchell Wallin Peter Kosa Bibiana Bielekova Fred Lublin Olaf Stuve |
| author_sort | Yinan Zhang |
| collection | DOAJ |
| description | Background: Disease-modifying therapies (DMTs) for multiple sclerosis (MS) are approved for the treatment of disease activity and are effective in reducing relapses and new magnetic resonance imaging (MRI) lesions. However, disease activity generally subsides with time, and age-dependent changes in DMT efficacy are not well-established. We aimed to investigate whether age impacts the efficacy of DMTs in treating disease activity in patients with relapsing–remitting MS (RRMS). Methods: DMT efficacy related to age was assessed through a meta-analysis of clinical trials that evaluated the efficacy of DMTs in RRMS patients as measured by reductions in the annualized relapse rate (ARR), new T2 lesions, and gadolinium-enhanced lesions on MRI. Using the mean baseline patient age from each trial, a weighted linear regression was fitted to determine whether age was associated with treatment efficacy on a group level. Results: Group-level data from a total of 28,082 patients from 26 trials of 14 different DMTs were included in the meta-analysis. There were no statistically significant associations between age and reductions in ARR, new T2 lesions, and gadolinium-enhanced lesions of the treatment group compared with placebo. Conclusion: DMTs for RRMS show efficacy in treating disease activity independent of age as demonstrated by group-level data from DMT clinical trials. Nevertheless, clinical trials select for patients with baseline disease activity regardless of age, thereby not representing real-world patients with RRMS, where disease activity declines with age. |
| first_indexed | 2024-12-18T10:50:00Z |
| format | Article |
| id | doaj.art-985ecce9eafa4c9c826d2ce226f510b0 |
| institution | Directory Open Access Journal |
| issn | 1756-2864 |
| language | English |
| last_indexed | 2024-12-18T10:50:00Z |
| publishDate | 2020-10-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Therapeutic Advances in Neurological Disorders |
| spelling | doaj.art-985ecce9eafa4c9c826d2ce226f510b02022-12-21T21:10:29ZengSAGE PublishingTherapeutic Advances in Neurological Disorders1756-28642020-10-011310.1177/1756286420969016Aging and efficacy of disease-modifying therapies in multiple sclerosis: a meta-analysis of clinical trialsYinan ZhangNatalia Gonzalez CalditoAfsaneh ShiraniAmber SalterGary CutterWilliam CulpepperMitchell WallinPeter KosaBibiana BielekovaFred LublinOlaf StuveBackground: Disease-modifying therapies (DMTs) for multiple sclerosis (MS) are approved for the treatment of disease activity and are effective in reducing relapses and new magnetic resonance imaging (MRI) lesions. However, disease activity generally subsides with time, and age-dependent changes in DMT efficacy are not well-established. We aimed to investigate whether age impacts the efficacy of DMTs in treating disease activity in patients with relapsing–remitting MS (RRMS). Methods: DMT efficacy related to age was assessed through a meta-analysis of clinical trials that evaluated the efficacy of DMTs in RRMS patients as measured by reductions in the annualized relapse rate (ARR), new T2 lesions, and gadolinium-enhanced lesions on MRI. Using the mean baseline patient age from each trial, a weighted linear regression was fitted to determine whether age was associated with treatment efficacy on a group level. Results: Group-level data from a total of 28,082 patients from 26 trials of 14 different DMTs were included in the meta-analysis. There were no statistically significant associations between age and reductions in ARR, new T2 lesions, and gadolinium-enhanced lesions of the treatment group compared with placebo. Conclusion: DMTs for RRMS show efficacy in treating disease activity independent of age as demonstrated by group-level data from DMT clinical trials. Nevertheless, clinical trials select for patients with baseline disease activity regardless of age, thereby not representing real-world patients with RRMS, where disease activity declines with age.https://doi.org/10.1177/1756286420969016 |
| spellingShingle | Yinan Zhang Natalia Gonzalez Caldito Afsaneh Shirani Amber Salter Gary Cutter William Culpepper Mitchell Wallin Peter Kosa Bibiana Bielekova Fred Lublin Olaf Stuve Aging and efficacy of disease-modifying therapies in multiple sclerosis: a meta-analysis of clinical trials Therapeutic Advances in Neurological Disorders |
| title | Aging and efficacy of disease-modifying therapies in multiple sclerosis: a meta-analysis of clinical trials |
| title_full | Aging and efficacy of disease-modifying therapies in multiple sclerosis: a meta-analysis of clinical trials |
| title_fullStr | Aging and efficacy of disease-modifying therapies in multiple sclerosis: a meta-analysis of clinical trials |
| title_full_unstemmed | Aging and efficacy of disease-modifying therapies in multiple sclerosis: a meta-analysis of clinical trials |
| title_short | Aging and efficacy of disease-modifying therapies in multiple sclerosis: a meta-analysis of clinical trials |
| title_sort | aging and efficacy of disease modifying therapies in multiple sclerosis a meta analysis of clinical trials |
| url | https://doi.org/10.1177/1756286420969016 |
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