Treatments for fatigue in multiple sclerosis: a rapid and systematic review
Branas P, Jordan R, Fry-Smith A, Burls A, Hyde C
Record ID 32000000908
- To identify current treatments for fatigue in MS and their evidence-base.
- To systematically review the evidence for those treatments that have been investigated in more than one rigorous study, in order to determine their effectiveness and cost-effectiveness.
Authors' results and conclusions:
Effectiveness of amantadine One parallel and three crossover trials were found, involving a total of 236 people with MS. All studies were open to bias. All studies showed a pattern in favour of amantadine compared with placebo, but there is considerable uncertainty about the validity and clinical significance of this finding. This pattern of benefit was considerably undermined when different assumptions were used in the sensitivity analysis.
Effectiveness of pemoline One parallel and one crossover trial were found involving a total of 126 people with MS. Both studies were open to bias. There was no overall tendency in favour of pemoline over placebo and an excess of reports of adverse effects with pemoline.
There is insufficient evidence to allow people with MS, clinicians or policy makers to make informed decisions on the appropriate use of the many treatments on offer.
Only amantadine appears to have some proven ability to alleviate the fatigue in MS, though only a proportion of users will obtain benefit and then only some of these patients will benefit sufficiently to take the drug in the long term.
English language abstract:
An English language summary is available
- Costs and Cost Analysis
- Multiple Sclerosis
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