siponimod and Drug-Related-Side-Effects-and-Adverse-Reactions

All agents engaging sphongosine-1-phospate receptors (S1PRs) will have some cardiovascular effect. This study aimed to elucidate the risk of cardiovascular adverse events (AEs) in patients with multiple sclerosis (MS) treated with S1PR modulators (S1PRMs).. We systematically searched the PubMed, EMBASE, and Cochrane Library databases for randomised controlled trials (RCTs) published through January 5, 2021. Relative risks (RRs) and 95% confidence intervals (CIs) were calculated using the random-effects model. Sensitivity analyses and meta-regression were performed.. Seventeen RCTs (12 for fingolimod; 3 for ozanimod; 2 for siponimod) involving 13,295 patients were included. Compared with the control treatment, S1PRMs significantly increased the risk of cardiovascular AEs (RR, 2.21; 95% CI, 1.58-3.10; I. S1PRM use increased the risk of cardiovascular AEs by 1.21 times in patients with MS, and increased risks for bradyarrhythmia and hypertension were at 2.92- and 2.00-fold, respectively. These findings can help clinicians assess the risk of cardiovascular AEs in patients treated with S1PRMs.. The PROSPERO ID is CRD42020183215.

Topics: Azetidines; Benzyl Compounds; Bradycardia; Drug-Related Side Effects and Adverse Reactions; Fingolimod Hydrochloride; Humans; Hypertension; Indans; Multiple Sclerosis; Oxadiazoles; Randomized Controlled Trials as Topic; Risk; Sphingosine 1 Phosphate Receptor Modulators; Sphingosine-1-Phosphate Receptors