Background Multiple sclerosis is a chronic inflammatory disorder of the central nervous system. Statins have demonstrated anti-inflammatory and immunomodulatory properties in this setting. Several clinical studies of different statins, given alone or in combination with interferon, for relapsing-remitting multiple sclerosis (RRMS) have been conducted with conflicting results.
Purpose To review the efficacy and safety of statins in combination with interferon treatment in patients with RRMS.
Material and methods A systematic review of the literature and meta-analysis was performed by searching in MEDLINE, Cochrane CENTRAL Registry and EMBASE, to October 2014. Trials comparing the use of interferon alone or combined with statins in adult patients with RRMS were identified. Trials with a score ≥3 according to the Jadad scale were considered. Pooled effect was calculated for the following outcomes: risk of relapse, treatment withdrawal due to adverse effects and risk of myalgia.
A DerSimonian-Laird random-effects model was used to calculate pooled Odds Ratios. Statistical heterogeneity was examined using the I2 statistic. For significant differences, publication bias was estimated by using the Rosenthal index.
Results Six trials were included in the analysis (n = 1,484; range of follow-up = 6–36 months). The evaluated statin was simvastatin in three trials and atorvastatin in two trials. The other trial also included pravastatin, lovastatin and fluvastatin. No significant difference was found between the statin and control group regarding the risk of relapse (OR, 1.06; 95% confidence interval [CI], 0.64 to 1.74; p = 0.82), risk of myalgia (OR, 1.56; 95% CI, 0.59, 4.11; p = 0.36) or risk of withdrawal due to adverse effects (OR, 1.37; 95% CI, 0.57 to 3.30; p = 0.49). I2 test revealed that heterogeneity was low for all the analyses performed.
Conclusion Our results revealed that the addition of statins to interferon treatment did not significantly affect the risk of relapse, myalgia or treatment withdrawal due to adverse effects in patients with RRMS.
References and/or Acknowledgements No conflict of interest.
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