Author Of 1 Presentation
P0291 - Association of Headache with B-cell Targeted Therapies in Multiple Sclerosis patients. (ID 1796)
Abstract
Background
Patients with Multiple Sclerosis (MS) have an increased incidence of headache, whereas the mechanism and the various co-factors are poorly understood. Among them, MS therapies are considered to play a role. Nonetheless, there is not enough data that correlate MS therapies with headache.
Objectives
The aim of the present study is to conduct a systematical review of the current literature towards identifying any possible association between B-cell MS therapies and increased headache incidence.
Methods
Systematic literature search was conducted using PubMed/MEDLINE database, clinicaltrials.gov and clinicaltrialsregister.eu searching clinical trials of B-cell depleting therapies in MS (i.e. ofatumumab, ocrelizumab, rituximab, ublituximab, cladribine) and investigating a possible role in the incidence of headache in MS patients. PRISMA guidelines for systematic reviews were applied. Risk of bias was evaluated using the Cochrane Risk of Bias tool. Relative risk (RR) and confidence intervals (CI) were calculated.
Results
In total, 9 randomized-control trials with 3785 patients were included in this study. The overall pooled relative risk of headaches in MS patients receiving B-cell depleting therapies was estimated to 1.12; p=0.15 (95% CI: 0.96 – 1.30; I2=9.32%; Q=7.42 [p=0.49]). Subgroup analysis of the studies in which cladribine was given as B-cell targeted therapy, showed a statistically significant higher increased risk of headache with a risk ratio of 1.19; p=0.04 (95% CI 1.01 – 1.42; I2=0%; Q=1.07 [p=0.59]).
Conclusions
B-cell targeted MS therapies do not correlate with increased incidence of headache as an adverse effect, even though a trend is shown. Further sub-analysis revealed that cladribine alone is associated with increased incidence of headache. More research is needed to elucidate the pathogenetic mechanism of headache induction, as well as, to identify headache prevention strategies.