title: Sex differences in outcomes of disease-modifying treatments for multiple sclerosis: A systematic review.
abstract: BACKGROUND
  Multiple sclerosis (MS) is a chronic immune mediated demyelinating disease of the central nervous system that exhibits sexual dimorphism and may benefit from sex-specific treatment. To investigate a potential influence of sex on immunomodulatory therapeutic effects in patients with MS, we performed a comprehensive analysis of published studies examining sex differences in the effects of disease-modifying treatments (DMTs) for MS.
  
  
  METHODS
  PubMed, Cochrane Library, and Web of Science databases were searched for clinical studies involving patients with MS who were undergoing DMTs. Studies were included if they investigated sex differences in DMT outcomes.
  
  
  RESULTS
  Fourteen studies with 11,425 participants were included; 11 of these studies were randomized controlled trials, and 3 were cohort studies. Although the studies did occasionally show sex-specific differences for some clinical outcomes in patients with MS who received DMTs, the limitation of subgroup analysis design made it difficult to draw conclusions on the direction or the extent of the sex-based effect.
  
  
  CONCLUSIONS
  No clear sex-based differences in response to DMTs have been documented to date. More studies will be needed to better elucidate the presence of sex differences on the DMT effects.
authors.affiliation: Department of Neurology, The Third Affiliated Hospital of Sun Yet-senYet-sen University, Guangzhou, China.
authors.forename: Rui
authors.initials: R
authors.lastname: Li
authors.affiliation: Department of Neurology, The Third Affiliated Hospital of Sun Yet-senYet-sen University, Guangzhou, China.
authors.forename: Xiaobo
authors.initials: X
authors.lastname: Sun
authors.affiliation: Department of Neurology, The Third Affiliated Hospital of Sun Yet-senYet-sen University, Guangzhou, China.
authors.forename: Yaqing
authors.initials: Y
authors.lastname: Shu
authors.affiliation: Department of Neurology, The Third Affiliated Hospital of Sun Yet-senYet-sen University, Guangzhou, China.
authors.forename: Zhifeng
authors.initials: Z
authors.lastname: Mao
authors.affiliation: Department of Neurology, The Third Affiliated Hospital of Sun Yet-senYet-sen University, Guangzhou, China.
authors.forename: Li
authors.initials: L
authors.lastname: Xiao
authors.affiliation: Department of Neurology, The Third Affiliated Hospital of Sun Yet-senYet-sen University, Guangzhou, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Qiu
authors.affiliation: Department of Neurology, The Third Affiliated Hospital of Sun Yet-senYet-sen University, Guangzhou, China.
authors.forename: Zhengqi
authors.initials: Z
authors.lastname: Lu
authors.affiliation: Department of Neurology, The Third Affiliated Hospital of Sun Yet-senYet-sen University, Guangzhou, China. Electronic address: huxueqiangzssy@qq.com.
authors.forename: Xueqiang
authors.initials: X
authors.lastname: Hu
mesh_terms: D006801:Humans; D009103:Multiple Sclerosis / Q000188:drug therapy* / Q000503:physiopathology*; D012727:Sex Characteristics
keywords: Disease-modifying treatment; Multiple sclerosis; Sex difference