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B-Cell Targeted Therapies in Patients with Multiple Sclerosis and Incidence of Headache: A Systematic Review and Meta-Analysis
dc.creator | Mavridis T., Papagiannakis N., Breza M., Vavougios G.D., Patas K., Daponte A., Laskaratos A., Archontakis-Barakakis P., Pantazopoulos I., Mitsikostas D.D. | en |
dc.date.accessioned | 2023-01-31T08:58:05Z | |
dc.date.available | 2023-01-31T08:58:05Z | |
dc.date.issued | 2022 | |
dc.identifier | 10.3390/jpm12091474 | |
dc.identifier.issn | 20754426 | |
dc.identifier.uri | http://hdl.handle.net/11615/76433 | |
dc.description.abstract | Background: Multiple Sclerosis treatment with B-cell targeted therapies may be associated with an increased incidence of headache. We aimed to find and compare the association of B-cell targeted therapies with the incidence of headache in patients with Multiple Sclerosis. Methods: In a systematic based approach, the following databases were searched from inception until the 6th of June 2020: Pubmed/MEDLINE, ClinicalTrials.gov, EU Clinical Trials Register. Only randomized clinical trials (RCTs) enrolling patients with Multiple Sclerosis comparing B-cell targeted therapies (Rituximab, Ocrelizumab, Ofatumumab, Ublituximab or Cladribine) with placebo were selected for the systematic review and further meta-analysis. PRISMA guidelines were followed at all stages of the systematic review. The primary outcome was an all-cause headache of B-cell targeting therapy in patients with Multiple Sclerosis. Results: Nine RCTs were included. Compared with placebo, treatment with B-cell targeting therapies revealed a trend in headache risk, but it was not statistically significant (Relative Risk 1.12 [95% Confidence Interval 0.96–1.30]; p = 0.15; I2 = 9.32%). Surprisingly, in a sub-group analysis, Cladribine was statistically significant for an increase in headache risk (RR 1.20 [95% CI 1.006–1.42]; p = 0.042; I2 = 0%; 3 studies with 2107 participants). Conclusions: Even though a trend is shown, B-cell targeted therapies do not correlate with an increased incidence of headache as an adverse effect. Sub-analyses revealed a significant association between Cladribine alone and an increased incidence of headache. Whereas a purinergic signaling cascade is proposed as a mechanism of action, further research is needed to unravel the underlying pathogenetic mechanism of headache induction and establish headache prevention strategies. © 2022 by the authors. | en |
dc.language.iso | en | en |
dc.source | Journal of Personalized Medicine | en |
dc.source.uri | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85138654501&doi=10.3390%2fjpm12091474&partnerID=40&md5=9c18ff11625c2026f5279952676b76ca | |
dc.subject | calcitonin gene related peptide | en |
dc.subject | cladribine | en |
dc.subject | ocrelizumab | en |
dc.subject | ofatumumab | en |
dc.subject | rituximab | en |
dc.subject | ublituximab | en |
dc.subject | drug therapy | en |
dc.subject | headache | en |
dc.subject | human | en |
dc.subject | meta analysis | en |
dc.subject | multiple sclerosis | en |
dc.subject | nervous system inflammation | en |
dc.subject | purinergic signaling | en |
dc.subject | Review | en |
dc.subject | systematic review | en |
dc.subject | MDPI | en |
dc.title | B-Cell Targeted Therapies in Patients with Multiple Sclerosis and Incidence of Headache: A Systematic Review and Meta-Analysis | en |
dc.type | other | en |
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