Affiliation:
1. The Second Xiangya Hospital of Central South University, Changsha, Hunan
Province, 410011, China
2. Xiangya School of Nursing, Central South University, Changsha, Hunan
Province, 410013, China
3. Xiangya School of Medicine, Central South University, Changsha, Hunan
Province, 410013, China
Abstract
Objective:
This study aims to provide an overview of meta-analyses and systematic
reviews on the effectiveness and safety of immunosuppressive drug therapy for
neuromyelitis optica spectrum disorders (NMOSD) by evaluating the methodological
quality and reporting quality of reviews.
Methods:
The Chinese National Knowledge Infrastructure (CNKI), WanFang Data,
China Science and Technology Journal Database, Web of Science, the Cochrane
Library, PubMed, and Embase databases were searched to collect systematic reviews
or meta-analyses on the effectiveness and safety of immunosuppressive therapy for
NMOSD from inception to December 2, 2021. Two researchers independently
screened reviews and extracted data. Any differences in the procession of review
assessment between the two researchers were re-evaluated, and the disagreement was
resolved by discussion with other researchers. The following data were extracted:
author, year of publication, the country where the study was conducted, study type,
the number of included studies, sample size, risk bias tools, medication of
immunosuppressive therapy, and main outcomes. Then, the AMSTAR-2, which is a
critical appraisal tool for systematic reviews (2nd edition), and Grades of Recommendation,
Assessment, Development and Evaluation (GRADE) were used to evaluate the
methodological quality and reporting quality of evidence. A comprehensive analysis
was conducted on the outcomes for all included reviews.
Results:
A total of 15 reviews were included. Of the included reviews, 3 were
systematic reviews, 7 were meta-analyses, and 5 were systematic reviews and meta-
analyses. According to the AMSTAR-2 criteria, 6 studies had high quality, 1 study
had moderate quality, 4 studies had low quality, and 4 studies had critically low
quality. Based on the GRADE, neither evidence quality for effectiveness nor safety
was high.
Conclusions:
Immunosuppressive drug therapy is effective for patients with
NMOSD, but its safety is controversial. Due to the poor quality of evidence,
reliability needs to be considered. Thus, large sample, multi-center, double-blind,
randomized controlled studies are still needed in the future.
Publisher
Bentham Science Publishers Ltd.
Subject
Pharmacology (medical),Psychiatry and Mental health,Neurology (clinical),Neurology,Pharmacology,General Medicine