title: Efficacy of the Treatments Used in Multiple Sclerosis: From Meta-analysis to Number Needed to Treat.
abstract: The aim of this study was to analyze the efficacy of drugs used in relapsing-remitting multiple sclerosis, first- and second-line drugs, using the number needed to treat (NNT) as a measure of efficacy.
  
  
  METHODS
  Data from randomized clinical trials were analyzed for 3 categories of clinical efficacy outcomes: relapse, change in Expanded Disability Status Scale, and number of new lesions in magnetic resonance imaging. Meta-analysis results are expressed as odds ratios.
  
  
  RESULTS
  The global odds ratio was 0.41 (95% confidence interval [CI], 0.34-0.49). For analyzed clinical outcomes, the odds ratio was less for second-line drugs (odds ratio, 2.0). For all studied clinical conditions, in the control group, 47 of 100 patients do not get benefits, compared with 25 (95% CI, 18-32 patients) of 100 for the active treatment group. The NNT was 5 patients (95% CI, 4-7 patients). For the proportion of patients free of relapses, in the control group, 56 of 100 patients had a relapse at 2 years, compared with 37 of 100 patients in the treatment group, with an NNT of 6 patients (95% CI, 5-8 patients).
  
  
  CONCLUSIONS
  Active treatments produced statistically significant improvements compared with placebo.
authors.affiliation: *Health Economics & Rational Use of Drugs, Faculty of Medicine, University of Málaga, Institute of Biomedical Research in Málaga; †Multiple Sclerosis Unit, Virgen Macarena Hospital, Seville; ‡Department of Nursing and Podiatry, Faculty of Health Sciences, University of Malaga, Málaga; §Technological Innovation Group, Virgen del Rocío University Hospital, Seville; and ∥Department of Applied Economics, Faculty of Economics Sciences and Business, University of Granada, Granada, Spain.
authors.forename: Antonio J
authors.initials: AJ
authors.lastname: García-Ruiz
authors.forename: Guillermo
authors.initials: G
authors.lastname: Izquierdo-Ayuso
authors.forename: Guillermo
authors.initials: G
authors.lastname: Navarro-Mascarell
authors.forename: Ana C
authors.initials: AC
authors.lastname: Montesinos-Gálvez
authors.forename: Francisco
authors.initials: F
authors.lastname: Martos-Crespo
authors.forename: Francisco
authors.initials: F
authors.lastname: Jódar-Sánchez
authors.forename: Manuel
authors.initials: M
authors.lastname: Correa
authors.forename: Nuria
authors.initials: N
authors.lastname: García-Agua Soler
mesh_terms: D004185:Disability Evaluation; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D009103:Multiple Sclerosis / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence
chemical_list: D007166:Immunosuppressive Agents