Comparative effectiveness of interferons in relapsing–remitting multiple sclerosis: a meta-analysis of real-world studies

AbstractBackground: Differences between interferons have been evaluated for over 20 years. While randomized controlled trial (RCT) data is mainly used for assessments and strong data for causal inferences, it does not necessarily reflect everyday practice. Real-world data may provide additional information.Purpose: To assess the results, quality, and representativeness of observational studies directly comparing interferons (IFNs) in RRMS.Methods: Medline and Embase were searched for observational studies comparing IFN-beta-1a 30 mcg IM (Avonex1), IFN-beta-1a 44 mcg SC (Rebif2) and/or IFN-beta-1b 250 mcg SC (Betaseron3). Outcomes included annualized relapse rate (ARR), proportions relapse free, confirmed progression free, treatment persistence, and neutralizing antibodies rates (NABs) measured up to 5 years of treatment. Data was combined using random effects meta-analyses. Categorical values were analyzed using chi-squared and Mann–Whitney tests.Results: Thirty-six studies examining 32,026 patients (72.5...