Pereira Leonardo Gomes, Rodrigues Patrícia, Viero Fernanda Tibolla, Frare Julia Maria, Ramanzini Luís Guilherme, Trevisan Gabriela
Department of Physiology and Pharmacology, Graduated Program in Pharmacology, Federal University of Santa Maria (UFSM), 97105-900 Santa Maria (RS), Brazil.
Curr Neuropharmacol. 2022;20(8):1600-1612. doi: 10.2174/1570159X19666211101142115.
Multiple sclerosis (MS) is a chronic neurodegenerative, inflammatory, and autoimmune disease characterised by the demyelination of the central nervous system. One of the main approaches for treating MS is the use of disease-modifying therapies (DMTs). Among the DMTs are interferons (IFNs), which are cytokines responsible for controlling the activity of the immune system while exerting immunomodulatory, antiviral, and antiproliferative activities. IFN-beta (IFN-β) is the first-choice drug used to treat relapsing-remitting MS. However, the administration of IFN-β causes numerous painful adverse effects, resulting in lower adherence to the treatment. Therefore, this study aimed to investigate the headache and flu-like pain symptoms observed after IFNβ injection in MS patients using a systematic review and meta-analysis of randomised controlled trials. A total of 2370 articles were identified through research databases. Nine articles were included (three involving IFNβ-1b and six involving IFNβ-1a). All studies included in the meta-analysis had a low risk of bias. The odds ratio of headache and flu-like pain symptoms increased in MS patients treated with IFN-β. Thus, the adverse effects of headache and flu-like pain symptoms appear to be linked to IFN-β treatment in MS. The protocol of the study was registered in the Prospective International Registry of Systematic Reviews (registration number CRD42021227593).
多发性硬化症（MS）是一种慢性神经退行性、炎症性自身免疫疾病，其特征为中枢神经系统脱髓鞘。治疗MS的主要方法之一是使用疾病修正疗法（DMTs）。DMTs中包括干扰素（IFNs），它们是细胞因子，负责控制免疫系统的活动，同时发挥免疫调节、抗病毒和抗增殖活性。干扰素-β（IFN-β）是用于治疗复发缓解型MS的首选药物。然而，注射IFN-β会引起许多疼痛性不良反应，导致治疗依从性降低。因此，本研究旨在通过对随机对照试验进行系统评价和荟萃分析，调查MS患者注射IFNβ后出现的头痛和流感样疼痛症状。通过研究数据库共识别出2370篇文章。纳入9篇文章（3篇涉及IFNβ-1b，6篇涉及IFNβ-1a）。荟萃分析中纳入的所有研究偏倚风险均较低。接受IFN-β治疗的MS患者出现头痛和流感样疼痛症状的比值比增加。因此，头痛和流感样疼痛症状的不良反应似乎与MS患者接受IFN-β治疗有关。该研究方案已在国际前瞻性系统评价注册库注册（注册号CRD42021227593）。
