Dataset Information

Dalfampridine in the treatment of multiple sclerosis: a meta-analysis of randomised controlled trials.

ABSTRACT:

Background

Multiple sclerosis (MS) is a chronic illness involving the central nervous system (CNS) that is characterised by inflammation, demyelination, and degenerative changes. Dalfampridine is one of the available treatments for MS symptoms and comorbidities. This meta-analysis aimed to assess the safety and benefits of dalfampridine versus placebo in MS by summarising data deriving from previously published clinical randomised controlled studies (RCTs).

Results

A total of 9 RCTs were included in this meta-analysis, involving 1691 participants. There were significant differences between dalfampridine and placebo in terms of decreased 12-item Multiple Sclerosis Walking Scale score (weighted mean difference [WMD]?=??-?3.68, 95% confidence interval [CI] [-?5.55,?-?1.80], p?=?0.0001), improved response to the timed 25-foot walk test (relative risk [RR]?=?2.57, 95% CI [1.04, 6.33], p?=?0.04), increased 6-min walk test (WMD?=?18.40, 95% CI [1.30, 35.51], p?=?0.03), increased 9-Hole Peg Test score (WMD?=?1.33, 95% CI [0.60, 2.05], p?=?0.0004), and increased Symbol Digit Modalities Test score (WMD?=?4.47, 95% CI [3.91, 5.02], p?ConclusionDalfampridine exerts positive effects on walking ability, finger dexterity, and cognitive function. Treatment should be administered under the guidance of a physician or pharmacist given the higher incidence of adverse events.

SUBMITTER: Zhang E

PROVIDER: S-EPMC7885571 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

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Publications

Dalfampridine in the treatment of multiple sclerosis: a meta-analysis of randomised controlled trials.

Zhang Enyao E Tian Xin X Li Ruoming R Chen Chaoyang C Li Min M Ma Lingyun L Wei Ran R Zhou Ying Y Cui Yimin Y

Orphanet journal of rare diseases 20210215 1

<h4>Background</h4>Multiple sclerosis (MS) is a chronic illness involving the central nervous system (CNS) that is characterised by inflammation, demyelination, and degenerative changes. Dalfampridine is one of the available treatments for MS symptoms and comorbidities. This meta-analysis aimed to assess the safety and benefits of dalfampridine versus placebo in MS by summarising data deriving from previously published clinical randomised controlled studies (RCTs).<h4>Results</h4>A total of 9 RC ...[more]

PMID: 33588903

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Project description:ObjectivesTo determine and quantify differences in efficacy between treatment regimens for brucellosis.DesignSystematic review and meta-analysis of randomised controlled trials assessing different antibiotic regimens and durations of treatment for human brucellosis.Data sourcesPubMed, CENTRAL, Lilacs, conference proceedings, and bibliographies with no restrictions on language, study year, or publication status. Review methods Search, application of inclusion and exclusion criteria, data extraction, and assessment of methodological quality independently performed in duplicate. Primary outcomes were relapse and overall failure resulting from primary failure or relapse. Relative risks with 95% confidence intervals were calculated and pooled with a fixed effect model.Results30 trials and 77 treatment arms were included. Overall failure was significantly higher with doxycycline-rifampicin compared to doxycycline-streptomycin, mainly due to a higher rate of relapse (relative risk 2.80, 95% confidence interval 1.81 to 4.36; 13 trials, without heterogeneity). Results were consistent among patients with bacteraemia and complicated brucellosis. Doxycycline-streptomycin resulted in a significantly higher rate of failure than doxycycline-rifampicin-aminoglycoside (triple drug regimen) (2.50, 1.26 to 5.00; two trials). Gentamicin was not inferior to streptomycin (1.45, 0.52 to 4.00 for failure; two trials). Quinolones combined with rifampicin were significantly less effective than doxycycline combined with rifampicin or streptomycin (1.83, 1.11 to 3.02, for failure; five trials). Monotherapy was associated with a higher risk of failure than combined treatment when administered for a similar duration (2.56, 1.55 to 4.23; five trials). Treatment for six weeks or more offered an advantage over shorter treatment durations.ConclusionsThere are significant differences in effectiveness between currently recommended treatment regimens for brucellosis. The preferred treatment should be with dual or triple regimens including an aminoglycoside.

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Dataset Information

Dalfampridine in the treatment of multiple sclerosis: a meta-analysis of randomised controlled trials.

Background

Results

Publications

Dalfampridine in the treatment of multiple sclerosis: a meta-analysis of randomised controlled trials.

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