An overview of reviews with network meta-analyses comparing disease-modifying therapies for relapsing multiple sclerosis

Aim: An overview of published systematic reviews (SRs) with integrated network meta-analyses (NMAs) comparing disease-modifying therapies (DMTs) for relapsing multiple sclerosis (RMS) was conducted to help inform healthcare decision-making. Methods: We searched Embase, MEDLINE & REG; and Cochrane Database of Systematic Reviews from inception to May 2023. Full-text studies evaluating annualized relapse rate (ARR) and/or confirmed disability progression (CDP) were qualitatively compared. Methodological quality was assessed using SR and NMA questionnaires. Results: Twenty-one SRs with integrated NMAs were included. Studies varied in their conduct and reporting of the SR, the included primary evidence, treatments, and cross-trial heterogeneity assessment and their conduct and reporting of NMAs. The quality of the studies was variable. Monoclonal antibody therapies were determined to be the most efficacious DMTs for reducing ARR and delaying CDP. Conclusion: Future analyses should carefully consider and clearly report methods and results to permit accurate interpretation of NMA findings and better inform decision-making.