OBJECTIVES:

Both natalizumab and glatiramer acetate have been approved for use in disease-modifying treatment for relapsing-remitting multiple sclerosis in Kazakhstan. In this paper we attempt to conduct a review of natalizumab’s effectiveness using a network meta-analysis approach for comparing natalizumab and glatiramer acetate, with placebo as a common comparator.

METHODS:

In accordance with the defined search strategy and inclusion criteria, 2 identified trials on natalizumab and 3 identified trials on glatiramer acetate were included in the present analysis. Studies conducting sub-group analyses of data from previous trials were excluded in favour of inclusion of original studies. The common clinical end point was identified as the proportion of participants who experienced at least 1 relapse. Data were extracted from published articles and meta-analysis was performed using Stata software with “metan” package.

RESULTS:

The lower pooled estimate for the natalizumab studies (0.464, 95% CI: 0.323-0.666) compared to the pooled estimate for the glatiramer acetate studies (0.858, 95% CI: 0.766-0.961) may suggest greater efficacy for natalizumab compared to glatiramer acetate in regards to reducing relapses.

CONCLUSIONS:

While the results point to greater efficacy of natalizumab compared to glatiramer acetate, the limited number of studies and other limitations of the study design suggest that further research is needed to ascertain its preferability, in particular clinical trials with direct comparisons of various first-line treatments for relapsing-remitting multiple sclerosis.