Multiple Sclerosis (MS) is a chronic, autoimmune disease of the central nervous system (CNS) that affects about 250,000 people in the United States, although estimates are as high as 400,000 people. The treatment of MS involves acute relapse treatment with corticosteroids, symptom management with appropriate agents and disease modification with disease-modifying drugs (DMD). These agents modify the immune response that occurs in MS through various immunomodulatory or immunosuppressive effects. The purpose of this review is to compare the effectiveness and safety of different disease-modifying drugs for the treatment of MS.

Contents

• Introduction
  • Scope and Key Questions
• Methods
  • Literature Search
  • Study Selection
  • Study inclusion criteria
  • Data Abstraction
  • Validity Assessment
  • Data Synthesis
• Results
  • Overview
  • Summary
  • Detailed Assessment
    Key Questions 1 and 2: What is the comparative effectiveness of disease-modifying treatments for multiple sclerosis, including use of differing routes and schedules of administration? What is the comparative tolerability and safety of disease-modifying treatments for multiple sclerosis?
  • Key Question 3: What is the effectiveness of disease-modifying treatments for patients with a clinically isolated syndrome?
  • Key Question 4: Are there subgroups of patients based on demographics (age, racial or ethnic groups, and gender), other medications, or co-morbidities for which one disease-modifying treatment is more effective or associated with fewer adverse events?
• Summary
• References
• Appendixes
  • Appendix A. Search Strategies
  • Appendix B. Quality assessment methods of the Drug Effectiveness Review Project
  • Appendix C. Excluded Studies
  • Appendix D. Results of literature search
• Evidence Tables

The authors wish to acknowledge Dennis Bourdette, MD for providing clinical expertise during report production.

The Agency for Healthcare Research and Quality has not yet seen or approved this report.

The purpose of this report is to make available information regarding the comparative effectiveness and safety profiles of different drugs within pharmaceutical classes. Reports are not usage guidelines, nor should they be read as an endorsement of, or recommendation for, any particular drug, use or approach. Oregon Health & Science University does not recommend or endorse any guideline or recommendation developed by users of these reports.