Safety liver profile of teriflunomide versus interferon β in multiple sclerosis: Systematic review and indirect comparison meta-analysis

Paola Andrea Ortiz Salas; Camila Olarte Parra; Carlos Eduardo Pinzon Florez; Lina Maria Goez; Alberto Velez-van-Meerbeke; Jesus Hernan Rodriguez

doi:https://doi.org/10.1016/j.msard.2018.09.014

Safety liver profile of teriflunomide versus interferon β in multiple sclerosis: Systematic review and indirect comparison meta-analysis

Título traducido de la contribución: Perfil de seguridad hepática de la teriflunomida versus interferón β en la esclerosis múltiplePerfil de seguridad hepática de la teriflunomida versus interferón β en la esclerosis múltiple: Meta-análisis de revisión sistemática y comparación indirecta

Paola Andrea Ortiz Salas, Camila Olarte Parra, Carlos Eduardo Pinzon Florez, Lina Maria Goez, Alberto Velez-van-Meerbeke, Jesus Hernan Rodriguez

Producción científica: Contribución a una revista › Artículo › revisión exhaustiva

5 Citas (Scopus)

Resumen

OBJETIVOS:
Comparar el perfil de seguridad hepática del interferón β (IFN β) y la teriflunomida en pacientes con esclerosis múltiple.

MÉTODOS:
Se realizó un metanálisis de la red siguiendo la metodología de la Colaboración Cochrane. Se incluyeron todos los ensayos que comparaban todos los tipos de IFN β con teriflunomida, o fármacos modificadores de la enfermedad, o placebo en la EMRRR. Para este estudio se realizó un meta-análisis indirecto de la red de comparación dentro de un marco bayesiano con STATA (versión 13.0).

RESULTADOS:
Las búsquedas en la base de datos arrojaron 284 títulos, con 15 registros duplicados. Un estudio se identificó mediante búsquedas manuales. Se incluyeron 13 artículos en la revisión sistemática. Doce estudios compararon el IFN β (4203 pacientes) versus otro DMT. Cuatro estudios evaluaron la efectividad y la seguridad de la teriflunomida (906 pacientes) versus otro DMT. Seis estudios informaron lesión hepática inducida por fármacos según la Ley Hy. Sin embargo, sólo un estudio tuvo una comparación directa y no informó casos de toxicidad hepática en ninguno de los dos grupos, por lo que no fue posible estimar la OR. El metanálisis de las comparaciones indirectas muestra que no hubo diferencias estadísticamente significativas entre la teriflunomida y el IFN β (OR 1,09; IC del 95%: 0,02 a 2,16).

CONCLUSIONES:
No hubo diferencias significativas al comparar el IFN β y la teriflunomida en cuanto a la insuficiencia hepática o la elevación de las transaminasas.

Título traducido de la contribución	Perfil de seguridad hepática de la teriflunomida versus interferón β en la esclerosis múltiplePerfil de seguridad hepática de la teriflunomida versus interferón β en la esclerosis múltiple: Meta-análisis de revisión sistemática y comparación indirecta
Idioma original	Inglés estadounidense
Páginas (desde-hasta)	192-200
Número de páginas	9
Publicación	Multiple Sclerosis and Related Disorders
Volumen	26
DOI	https://doi.org/10.1016/j.msard.2018.09.014
Estado	Publicada - nov. 1 2018

Áreas temáticas de ASJC Scopus

Neurología
Neurología clínica

ODS de las Naciones Unidas

Este resultado contribuye a los siguientes Objetivos de Desarrollo Sostenible

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title = "Safety liver profile of teriflunomide versus interferon β in multiple sclerosis: Systematic review and indirect comparison meta-analysis",

abstract = "Objectives: To compare the liver safety profile of interferon β (IFN β) and teriflunomide in patients with multiple sclerosis. Methods: A network meta-analysis was carried out following the Cochrane Collaboration methodology. All trials comparing all types of IFN β with teriflunomide, or disease-modifying drugs, or placebo in RRMS were included. An indirect comparison network meta-analysis within a Bayesian framework with STATA (version 13.0) was done for this study. Results: The database searches yielded 284 titles, with 15 records as duplicates. One study was identified by manually searching. Thirteen articles were included in the systematic review. Twelve studies compared IFN β (4203 patients) vs another DMT. Four studies evaluated the effectiveness and safety of teriflunomide (906 patients) vs another DMT. Six studies reported drug-induced liver injury as per the Hy's Law. However, only one study had a direct comparison and reported no cases of liver toxicity in either group, so it was not possible to estimate the OR. The indirect comparisons metanalysis shows that there was no statistically-significant difference between teriflunomide and IFN β (OR 1.09, 95% CI 0.02–2.16). Conclusions: There were no significant difference when comparing IFN β and teriflunomide in terms of liver failure or elevation of transaminases.",

author = "Salas, {Paola Andrea Ortiz} and Parra, {Camila Olarte} and Florez, {Carlos Eduardo Pinzon} and Goez, {Lina Maria} and Alberto Velez-van-Meerbeke and Rodriguez, {Jesus Hernan}",

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doi = "https://doi.org/10.1016/j.msard.2018.09.014",

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volume = "26",

pages = "192--200",

journal = "Multiple Sclerosis and Related Disorders",

issn = "2211-0348",

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Safety liver profile of teriflunomide versus interferon β in multiple sclerosis: Systematic review and indirect comparison meta-analysis. / Salas, Paola Andrea Ortiz; Parra, Camila Olarte; Florez, Carlos Eduardo Pinzon et al.
En: Multiple Sclerosis and Related Disorders, Vol. 26, 01.11.2018, p. 192-200.

Producción científica: Contribución a una revista › Artículo › revisión exhaustiva

TY - JOUR

T1 - Safety liver profile of teriflunomide versus interferon β in multiple sclerosis: Systematic review and indirect comparison meta-analysis

AU - Salas, Paola Andrea Ortiz

AU - Parra, Camila Olarte

AU - Florez, Carlos Eduardo Pinzon

AU - Goez, Lina Maria

AU - Velez-van-Meerbeke, Alberto

AU - Rodriguez, Jesus Hernan

PY - 2018/11/1

Y1 - 2018/11/1

N2 - Objectives: To compare the liver safety profile of interferon β (IFN β) and teriflunomide in patients with multiple sclerosis. Methods: A network meta-analysis was carried out following the Cochrane Collaboration methodology. All trials comparing all types of IFN β with teriflunomide, or disease-modifying drugs, or placebo in RRMS were included. An indirect comparison network meta-analysis within a Bayesian framework with STATA (version 13.0) was done for this study. Results: The database searches yielded 284 titles, with 15 records as duplicates. One study was identified by manually searching. Thirteen articles were included in the systematic review. Twelve studies compared IFN β (4203 patients) vs another DMT. Four studies evaluated the effectiveness and safety of teriflunomide (906 patients) vs another DMT. Six studies reported drug-induced liver injury as per the Hy's Law. However, only one study had a direct comparison and reported no cases of liver toxicity in either group, so it was not possible to estimate the OR. The indirect comparisons metanalysis shows that there was no statistically-significant difference between teriflunomide and IFN β (OR 1.09, 95% CI 0.02–2.16). Conclusions: There were no significant difference when comparing IFN β and teriflunomide in terms of liver failure or elevation of transaminases.

AB - Objectives: To compare the liver safety profile of interferon β (IFN β) and teriflunomide in patients with multiple sclerosis. Methods: A network meta-analysis was carried out following the Cochrane Collaboration methodology. All trials comparing all types of IFN β with teriflunomide, or disease-modifying drugs, or placebo in RRMS were included. An indirect comparison network meta-analysis within a Bayesian framework with STATA (version 13.0) was done for this study. Results: The database searches yielded 284 titles, with 15 records as duplicates. One study was identified by manually searching. Thirteen articles were included in the systematic review. Twelve studies compared IFN β (4203 patients) vs another DMT. Four studies evaluated the effectiveness and safety of teriflunomide (906 patients) vs another DMT. Six studies reported drug-induced liver injury as per the Hy's Law. However, only one study had a direct comparison and reported no cases of liver toxicity in either group, so it was not possible to estimate the OR. The indirect comparisons metanalysis shows that there was no statistically-significant difference between teriflunomide and IFN β (OR 1.09, 95% CI 0.02–2.16). Conclusions: There were no significant difference when comparing IFN β and teriflunomide in terms of liver failure or elevation of transaminases.

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