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SYSTEMATIC REVIEW article

Front. Neurol.
Sec. Multiple Sclerosis and Neuroimmunology
Volume 15 - 2024 | doi: 10.3389/fneur.2024.1479476

Comparative Efficacy and Tolerability of Ublituximab Versus other Monoclonal Antibodies in the Treatment of Relapsing Multiple Sclerosis: A Systematic Review and Network Meta-Analysis of Randomized Trials

Provisionally accepted
Eoin Moloney Eoin Moloney 1*Atefeh Mashayekhi Atefeh Mashayekhi 1Sakshi Sharma Sakshi Sharma 1Vasileios Kontogiannis Vasileios Kontogiannis 1Amir Ansaripour Amir Ansaripour 2Wallace Brownlee Wallace Brownlee 3,4David Paling David Paling 5Mehdi Javanbakht Mehdi Javanbakht 1
  • 1 Optimax Access, Southampton, United Kingdom
  • 2 Optimax Access, Rotterdam, Netherlands
  • 3 Queen Square Multiple Sclerosis Centre, Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, England, United Kingdom
  • 4 NIHR University College London Hospitals Biomedical Research Centre, London, United Kingdom
  • 5 Department of Neurology, Royal Hallamshire Hospital, Sheffield, United Kingdom

The final, formatted version of the article will be published soon.

    Background: Relapsing multiple sclerosis (RMS) is a chronic, inflammatory disease of the central nervous system. Ublituximab, an anti-CD20 monoclonal antibody (mAbmAb), is indicated for the treatment of RMS. We performed a systematic literature review (SLR) to identify randomized trials reporting the clinical efficacy and tolerability of ublituximab or comparator disease-modifying therapies (DMTs) for treatment of RMS, and assessed their comparative effects using network meta-analysis (NMA).The SLR involved a comprehensive search across various medical databases to identify relevant studies. Included studies were randomized controlled trials (RCTs) of an adult RMS population, focusing on treatment with at least one of ublituximab, alemtuzumab, natalizumab, ocrelizumab, or ofatumumab. For outcomes included in the NMA (annualized relapse rate (ARR), confirmed disability progression (CDP), and treatment discontinuation rate), rate ratios (RR) or hazard ratios (HR), along with their 95% confidence intervals (CIs), were calculated. We performed NMA using a contrast-based random-effects model within a frequentist framework for all outcomes. Ranking probabilities among comparators, and intervention rankings for the NMA, were estimated using surface under the cumulative ranking curve (SUCRA).We included 15 RCTs in the review. For the ARR outcome, there was no statistically significant difference between ublituximab and the other included mmAbsAbs (ofatumumab (RR 1.02 [95% CI 0.64-1.62]), natalizumab (RR 0.99 [0.59-1.65]), alemtuzumab (RR 0.86 [0.51-1.46]), and ocrelizumab (RR 0.75 [0.44-1.28])). For CDP at 6 months, our results showed no statistically significant difference between ublituximab and the comparator mAbsmAbs ), natalizumab ), alemtuzumab (HR 1.25

    Keywords: Relapsing multiple sclerosis, Relapsing-remitting, secondary progressive, monoclonal antibodies, ublituximab, Systematic review, Network meta-analysis

    Received: 14 Aug 2024; Accepted: 18 Nov 2024.

    Copyright: © 2024 Moloney, Mashayekhi, Sharma, Kontogiannis, Ansaripour, Brownlee, Paling and Javanbakht. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Eoin Moloney, Optimax Access, Southampton, United Kingdom

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.