Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

26 questions · 26 findings · 4 reviews · Multiple Sclerosis and Rare Diseases of the CNS

No studies found 2 · 7.7%GRADE not reported 0 · 0%Very low 7 · 26.9%Low 9 · 34.6%Moderate 8 · 30.8%High 0 · 0%

Ocrelizumab vs placebo

Number of adverse events requiring discontinuation of treatment ‐ not reported · primary progressive multiple sclerosis

Ocrelizumab showed no clear difference in number of participants experiencing treatment discontinuation caused… compared with placebo (low certainty).

1 finding from 1 review

Ocrelizumab vs interferon beta‐1a

Number of participants with adverse events leading to study discontinuation · patients with relapsing‐remitting multiple sclerosis

Ocrelizumab may leads to lower number of participants experiencing treatment discontinuation caused… compared with interferon beta‐1a (low certainty).

1 finding from 1 review

Alemtuzumab 24 mg vs interferon beta‐1a

Number of participants with adverse events leading to study discontinuation · patients with relapsing‐remitting multiple sclerosis

It is very uncertain whether alemtuzumab 24 mg changes number of participants experiencing treatment discontinuation caused… compared with interferon beta 1a (very low certainty).

1 finding from 1 review

Alemtuzumab 12 mg vs interferon beta‐1a

Number of participants with adverse events leading to study discontinuation · patients with relapsing‐remitting multiple sclerosis

Alemtuzumab 12 mg may leads to lower number of participants experiencing treatment discontinuation caused… compared with interferon beta 1a (low certainty).

1 finding from 1 review

Are disease‐modifying drugs for a first attack suggestive of multiple sclerosis (MS) effective and safe vs placebo?

Discontinuation of medication due to adverse events

It is very uncertain whether are disease‐modifying drugs for a first attack suggestive of… changes withdrawls or drug discontinuation due to adverse events during 24… compared with placebo? (very low certainty).

1 finding from 1 review

Intervention not reported

Alemtuzumab No direct evidence · Patients with RRMS Interventions: Alemtuzumab, azathioprine, cladribine, daclizumab, dimethylfumarate, fingolimod, glatiramer acetate,…

The intervention probably leads to lower alemtuzumab No direct evidence (moderate certainty).

1 finding from 1 review

Intervention not reported

Azathioprine (Direct evidence; 1 RCT; 54 participants) · Patients with RRMS Interventions: Alemtuzumab, azathioprine, cladribine, daclizumab, dimethylfumarate, fingolimod, glatiramer acetate,…

It is very uncertain whether the intervention changes azathioprine (Direct evidence; 1 RCT; 54 participants) (very low certainty).

1 finding from 1 review

Intervention not reported

Cladribine (Direct evidence; 1 RCT; 1326 participants) · Patients with RRMS Interventions: Alemtuzumab, azathioprine, cladribine, daclizumab, dimethylfumarate, fingolimod, glatiramer acetate,…

The intervention showed no clear difference in cladribine (Direct evidence; 1 RCT; 1326 participants) (low certainty).

1 finding from 1 review

Intervention not reported

Daclizumab (Direct evidence; 1 RCT; 600 participants) · Patients with RRMS Interventions: Alemtuzumab, azathioprine, cladribine, daclizumab, dimethylfumarate, fingolimod, glatiramer acetate,…

The intervention probably leads to higher daclizumab (Direct evidence; 1 RCT; 600 participants) (moderate certainty).

1 finding from 1 review

Intervention not reported

Dimethylfumarate (Direct evidence; 2 RCTs; 2300 participants) · Patients with RRMS Interventions: Alemtuzumab, azathioprine, cladribine, daclizumab, dimethylfumarate, fingolimod, glatiramer acetate,…

The intervention showed no clear difference in dimethylfumarate (Direct evidence; 2 RCTs; 2300 participants) (low certainty).

1 finding from 1 review

Intervention not reported

Fingolimod (Direct evidence; 2 RCTs; 2355 participants) · Patients with RRMS Interventions: Alemtuzumab, azathioprine, cladribine, daclizumab, dimethylfumarate, fingolimod, glatiramer acetate,…

The intervention probably leads to higher fingolimod (Direct evidence; 2 RCTs; 2355 participants) (moderate certainty).

1 finding from 1 review

Intervention not reported

Glatiramer acetate (Direct evidence; 4 RCTs; 2419 participants) · Patients with RRMS Interventions: Alemtuzumab, azathioprine, cladribine, daclizumab, dimethylfumarate, fingolimod, glatiramer acetate,…

The intervention probably leads to higher glatiramer acetate (Direct evidence; 4 RCTs; 2419 participants) (moderate certainty).

1 finding from 1 review

Intervention not reported

Immunoglobulins (Direct evidence; 3 RCTs; 243 participants) · Patients with RRMS Interventions: Alemtuzumab, azathioprine, cladribine, daclizumab, dimethylfumarate, fingolimod, glatiramer acetate,…

It is very uncertain whether the intervention changes immunoglobulins (Direct evidence; 3 RCTs; 243 participants) (very low certainty).

1 finding from 1 review

Intervention not reported

Interferon beta 1a‐1b No direct evidence · Patients with RRMS Interventions: Alemtuzumab, azathioprine, cladribine, daclizumab, dimethylfumarate, fingolimod, glatiramer acetate,…

It is very uncertain whether the intervention changes interferon beta 1a‐1b No direct evidence (very low certainty).

1 finding from 1 review

Intervention not reported

Interferon beta‐1b (Direct evidence; 1 RCT; 372 participants) · Patients with RRMS Interventions: Alemtuzumab, azathioprine, cladribine, daclizumab, dimethylfumarate, fingolimod, glatiramer acetate,…

The intervention may leads to higher interferon beta‐1b (Direct evidence; 1 RCT; 372 participants) (low certainty).

1 finding from 1 review

Intervention not reported

Interferon beta‐1a (Direct evidence; 2 RCTs; 1457 participants) · Patients with RRMS Interventions: Alemtuzumab, azathioprine, cladribine, daclizumab, dimethylfumarate, fingolimod, glatiramer acetate,…

The intervention showed no clear difference in interferon beta‐1a (Direct evidence; 2 RCTs; 1457 participants) (moderate certainty).

1 finding from 1 review

Intervention not reported

Laquinimod (Direct evidence; 3 RCTs; 3457 participants) · Patients with RRMS Interventions: Alemtuzumab, azathioprine, cladribine, daclizumab, dimethylfumarate, fingolimod, glatiramer acetate,…

The intervention showed no clear difference in laquinimod (Direct evidence; 3 RCTs; 3457 participants) (moderate certainty).

1 finding from 1 review

Intervention not reported

Pegylated interferon beta‐1a (Direct evidence; 1 RCT; 1512 participants) · Patients with RRMS Interventions: Alemtuzumab, azathioprine, cladribine, daclizumab, dimethylfumarate, fingolimod, glatiramer acetate,…

It is very uncertain whether the intervention changes pegylated interferon beta‐1a (Direct evidence; 1 RCT; 1512… (very low certainty).

1 finding from 1 review

Intervention not reported

Natalizumab (Direct evidence; 1 RCT; 939 participants) · Patients with RRMS Interventions: Alemtuzumab, azathioprine, cladribine, daclizumab, dimethylfumarate, fingolimod, glatiramer acetate,…

The intervention showed no clear difference in natalizumab (Direct evidence; 1 RCT; 939 participants) (moderate certainty).

1 finding from 1 review