Review Article

Association of Disease-Modifying Therapies with COVID-19 Susceptibility and Severity in Patients with Multiple Sclerosis: A Systematic Review and Network Meta-Analysis

Table 3

League table showing the results of network meta-analysis comparing the effect of DMTs on the severity of COVID-19.
(a) Results from univariate analyses

ALZ....1.04
(0.20, 5.40)
...

1.74
(0.28, 10.92)
DMF...0.60
(0.27, 1.35)
...
1.75
(0.26, 12.01)
1.01
(0.28, 3.65)
FNG..0.59
(0.22, 1.61)
...
1.35
(0.08, 21.89)
0.78
(0.07, 8.47)
0.77
(0.07, 9.01)
GA.0.77
(0.08, 7.27)
...
3.65
(0.52, 25.72)
2.10
(0.56, 7.91)
2.09
(0.49, 8.85)
2.71
(0.23, 32.21)
NTZ0.28
(0.10, 0.81)
...
1.04
(0.20, 5.40)
0.60
(0.27, 1.35)
0.59
(0.22, 1.61)
0.77
(0.08, 7.27)
0.28
(0.10, 0.81)
No DMT0.73
(0.18, 3.01)
0.49
(0.22, 1.07)
0.78
(0.31, 2.02)
0.76
(0.09, 6.67)
0.44
(0.09, 2.24)
0.43
(0.08, 2.45)
0.56
(0.04, 7.99)
0.21
(0.04, 1.21)
0.73
(0.18, 3.01)
OCR..
0.51
(0.08, 3.14)
0.29
(0.09, 0.90)
0.29
(0.08, 1.03)
0.37
(0.03, 4.04)
0.14
(0.04, 0.51)
0.49
(0.22, 1.07)
0.67
(0.13, 3.36)
RTX.
0.82
(0.12, 5.45)
0.47
(0.14, 1.63)
0.47
(0.12, 1.84)
0.60
(0.05, 6.91)
0.22
(0.05, 0.91)
0.78
(0.31, 2.02)
1.08
(0.20, 5.89)
1.62
(0.47, 5.52)
TRF

(b) Results from multivariate analyses

DMF....0.62
(0.40, 0.95)
.0.34
(0.12, 0.98)
.

1.14
(0.58, 2.22)
FNG...0.55
(0.32, 0.94)
...
0.95
(0.46, 1.96)
0.84
(0.38, 1.87)
GA..0.65
(0.36, 1.19)
...
1.49
(0.70, 3.14)
1.31
(0.57, 3.01)
1.56
(0.65, 3.74)
IFN.0.36
(0.18, 0.72)
.0.49
(0.10, 2.46)
.
1.24
(0.67, 2.30)
1.09
(0.53, 2.24)
1.30
(0.61, 2.80)
0.83
(0.38, 1.84)
NTZ0.51
(0.31, 0.86)
.0.23
(0.07, 0.78)
.
0.62
(0.42, 0.93)
0.55
(0.32, 0.94)
0.65
(0.36, 1.19)
0.42
(0.22, 0.79)
0.50
(0.31, 0.81)
No DMT0.61
(0.37, 1.02)
0.39
(0.20, 0.75)
1.37
(0.80, 2.36)
0.38
(0.20, 0.73)
0.34
(0.16, 0.70)
0.40
(0.18, 0.88)
0.26
(0.11, 0.58)
0.31
(0.15, 0.62)
0.61
(0.37, 1.02)
OCR..
0.32
(0.18, 0.57)
0.28
(0.14, 0.58)
0.34
(0.16, 0.73)
0.22
(0.10, 0.46)
0.26
(0.14, 0.48)
0.52
(0.32, 0.83)
0.84
(0.42, 1.69)
RTX0.93
(0.19, 4.57)
0.77
(0.40, 1.47)
0.67
(0.32, 1.42)
0.80
(0.37, 1.77)
0.52
(0.23, 1.17)
0.62
(0.31, 1.24)
1.23
(0.74, 2.06)
2.01
(0.97, 4.15)
2.39
(1.22, 4.66)
TRF

On the upper triangle, the effect size are direct comparisons; the effect sizes presented on lower triangle are network meta-analyses (indirect comparison). Comparisons should be read from left to right (example for upper triangle: OR (95% CI) of developing a severe COVID-19 in DMF compared to no DMT is 0.62 (0.40, 0.95); example for lower triangle: OR (95% CI) of developing a severe COVID-19 in DMF compared to FNG is 1.14 (0.58, 2.22). DMF: dimethyl fumarate; FNG: fingolimod; GA: glatiramer acetate; IFN: interferon; NTZ: natalizumab; TRF: teriflunomide; DMT: disease-modifying therapy; RTX: rituximab; OCR: ocrelizumab.