Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
Islamic Azad University of Zahedan, Zahedan, Iran.
CNS Neurosci Ther. 2022 May;28(5):648-657. doi: 10.1111/cns.13815. Epub 2022 Feb 25.
Previous research has shown that cerebral T1 hypointense lesions are positively correlated with the disability of multiple sclerosis (MS) patients. Hence, they could be used as an objective marker for evaluating the progression of the disease. Up to this date, there has not been a systematic evaluation of the effects of disease-modifying therapies (DMTs) on this prognostic marker.
To evaluate the effects of FDA-approved DMTs on the numbers and volume of T1 hypointense lesions in adult patients with MS.
We included studies with the mentioned desired outcomes. In March 2021, we searched MEDLINE (Ovid), Embase, and CENTRAL to find relevant studies. All included studies were assessed for the risk of bias using the RoB-2 tool. Extracted data were analyzed using a random-effects model. Certainty of evidence was assessed using GRADE.
Thirteen studies with 7484 participants were included. Meta-analysis revealed the mean difference between the intervention and comparator groups for the number of lesions was -1.3 (95% CI: -2.1, -0.5) and for the mean volume of lesions was -363.1 (95% CI: -611.6, -114.6). Certainty of evidence was judged to be moderate. Heterogeneity was considerable.
DMTs reduce the number and volume of T1 hypointense lesions. Although, these findings must be interpreted cautiously due to the high values of heterogeneity.
先前的研究表明，脑 T1 低信号病变与多发性硬化症（MS）患者的残疾程度呈正相关。因此，它们可以作为评估疾病进展的客观标志物。迄今为止，还没有对疾病修正疗法（DMT）对这一预后标志物的影响进行系统评估。
评估 FDA 批准的 DMT 对成人 MS 患者 T1 低信号病变数量和体积的影响。
我们纳入了具有上述预期结果的研究。2021 年 3 月，我们在 MEDLINE（Ovid）、Embase 和 CENTRAL 中搜索了相关研究。使用 RoB-2 工具评估所有纳入的研究的偏倚风险。使用随机效应模型分析提取的数据。使用 GRADE 评估证据的确定性。
纳入了 13 项研究，共 7484 名参与者。Meta 分析显示，干预组与对照组之间病变数量的平均差异为-1.3（95% CI：-2.1，-0.5），病变平均体积的差异为-363.1（95% CI：-611.6，-114.6）。证据确定性被判定为中度。异质性相当大。
DMT 减少 T1 低信号病变的数量和体积。尽管由于高度异质性，必须谨慎解释这些发现。
