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Occurrence of Multiple Sclerosis After Drug Exposure: Insights From Evidence Mapping
Occurrence of Multiple Sclerosis After Drug Exposure: Insights From Evidence Mapping
- Source :
- Drug safety. 40(9)
- Publication Year :
- 2017
-
Abstract
- Introduction: The role of drugs in the occurrence of multiple sclerosis (MS) is perceived to be insufficiently investigated. Objective: The aim of this study was to map and assess the evidence on MS occurrence after drug exposure, in order to identify possible signals of causal association. Methods: A search strategy was performed in MEDLINE and Embase as of July 2016; references consistent with the aim of the study were analysed to extract relevant measures of causal association between drugs and MS. The Newcastle-Ottawa Scale and appropriate guidelines from the International Society for Pharmacoepidemiology (ISPE) and the International Society of Pharmacovigilance (ISoP) were used to assess the quality of included studies. Results: After screening 832 articles, 58 were selected (of which 14 were found by checking the reference lists of reviews): 30 case reports and case series, 24 longitudinal studies and four randomized controlled trials. Seven longitudinal studies had good (at least 7 out of 9) quality scores, whereas case reports/case series presented several limitations. Half of included articles focused on immunomodulatory drugs (etanercept, infliximab and adalimumab), especially in case reports/series, suggesting an association with MS occurrence. Contraceptives and antibacterials were investigated in some population-based studies, without definite results. Conclusion: A heterogeneous pharmacological profile of identified classes emerged. Low strength of evidence and conflicting results highlighted the difficulties in addressing the possible contribution of drugs in MS occurrence. Methodological advances are needed, especially to control the confounding role of underlying disease for specific drug classes.
- Subjects :
- Drug
medicine.medical_specialty
Multiple Sclerosis
Drug-Related Side Effects and Adverse Reactions
media_common.quotation_subject
Population
MEDLINE
Pharmacology
Toxicology
law.invention
03 medical and health sciences
0302 clinical medicine
Randomized controlled trial
Contraceptive Agents
law
Risk Factors
Pharmacovigilance
medicine
Humans
Immunologic Factors
Pharmacology (medical)
Intensive care medicine
education
media_common
Randomized Controlled Trials as Topic
030203 arthritis & rheumatology
education.field_of_study
business.industry
Confounding
Pharmacoepidemiology
Infliximab
Anti-Bacterial Agents
business
030217 neurology & neurosurgery
medicine.drug
Subjects
Details
- ISSN :
- 11791942
- Volume :
- 40
- Issue :
- 9
- Database :
- OpenAIRE
- Journal :
- Drug safety
- Accession number :
- edsair.doi.dedup.....95b2508e64834b06b8221a91775391f9