Pharmacological Interventions for Symptomatic Management of Neuromyelitis Optica Spectrum Disorder (NMOSD) : A Network Meta-analysis of Randomised Controlled Trials
Malavika Rudrakumar1, Aman Bhonsale2, Suhrud Panchawagh3, Sanskruti Mote2, Anmol Kaur4, Ansh Gadhiya2, Mokshita Gundlagutta2, Himanshu Garg2, Khushi Suresh Ku Sonchhatra2, Uditha Sai Kolamala2
1St. John's Medical College, 2All India Institute of Medical Sciences, Nagpur, 3SKN Medical College, 4Lady Hardinge Medical College and Associated Hospitals
Objective:
To evaluate the efficacy of pharmacological interventions in managing Neuromyelitis Optica Spectrum Disorder (NMOSD) symptoms through a network meta-analysis (NMA) and systematic review.
Background:
Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune condition affecting the optic nerves and spinal cord, leading to significant neurological deficits. Treatments like rituximab and eculizumab help reduce relapses, but further research is essential to optimize therapeutic strategies and enhance long-term patient outcomes
Design/Methods:
To evaluate the efficacy of pharmacological interventions in managing Neuromyelitis Optica Spectrum Disorder (NMOSD) symptoms through a network meta-analysis (NMA) and systematic review.
Results:
Satralizumab marginally improves disability scores over placebo, evidenced by a small and statistically insignificant effect size (SMD = 0.25, 95% CI -0.17 to 0.68). Eculizumab significantly reduced relapse rates compared to placebo (SMD = -0.35, 95% CI -0.70 to 0.00), with the ranking plot confirming its superiority in this outcome (P-score = 0.941).
Conclusions:
In conclusion, the NMA demonstrates variable efficacy of different treatments for NMOSD across several symptomatic outcomes. Ravulizumab emerges as the most effective treatment for reducing disability, while Eculizumab leads in preventing relapses.
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