Effects of natalizumab on oligoclonal bands in the cerebrospinal fluid of patients with multiple sclerosis: a systematic review and meta-analysis.
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| Title: | Effects of natalizumab on oligoclonal bands in the cerebrospinal fluid of patients with multiple sclerosis: a systematic review and meta-analysis. |
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| Authors: | Liampas, Andreas (AUTHOR), Tseriotis, Vasilis-Spyridon (AUTHOR), Mavridis, Theodoros (AUTHOR), Vavougios, George D. (AUTHOR), Zis, Panagiotis (AUTHOR), Hadjigeorgiou, Georgios M. (AUTHOR), Bargiotas, Panagiotis (AUTHOR), Pourzitaki, Chryssa (AUTHOR), Artemiadis, Artemios (AUTHOR) |
| Source: | Neurological Sciences. Apr2025, Vol. 46 Issue 4, p1541-1553. 13p. |
| Subjects: | Plasma cells, Cerebrospinal fluid, Prognosis, Multiple sclerosis, Natalizumab |
| Abstract: | Introduction: Oligoclonal bands (OCBs) in cerebrospinal fluid (CSF) are utilized for diagnosing multiple sclerosis (MS), as they are found in 95% of patients. Additionally, OCBs are linked to disease prognosis. The primary contributors to OCB production are long-lived plasma cells. This study aims to quantify the impact of natalizumab (NTZ) on OCB levels in the CSF of MS patients. Methods: A systematic search on MEDLINE, SCOPUS and Web of Science for English-written and peer-reviewed longitudinal studies on adults was performed. Methodological quality was assessed with the Newcastle–Ottawa Scale. Proportional meta-analysis was performed in R using a generalized linear mixed-effects model. We investigated heterogeneity with influence diagnostics, sensitivity analysis and meta-regression. Results: Eight eligible studies of adequate quality with a total sample of 326 relapsing–remitting MS patients were included. A summary rate of 14.07% [95% CI, 4.48%—36.36%] for complete loss of OCBs and 42.02% [95% CI, 15.23%—74.51%] for reduction in OCB number or intensity was observed, both with considerable heterogeneity. Pooled estimates dropped (11% [95% CI, 0.04%—0.29%] and 34% [95% CI, 0.11%—0.68%] respectively) after the identification of an influential study. Multivariable meta-regression identified IgG index as a factor contributing to heterogeneity (adj. p = 0.0279), regarding reduction of OCB number or intensity. Discussion: In conclusion, our systematic review and meta-analysis showed that NTZ can lead to reduction of intrathecal OCBs in MS patients, indicating a possible effect of NTZ on memory plasma cells, which are the main source of OCBs in MS. [ABSTRACT FROM AUTHOR] |
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| Database: | Psychology and Behavioral Sciences Collection |
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