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Sex Hormone Therapy in Multiple Sclerosis: A Systematic Review of Clinical Trials

Monir Shayestehfar1, Mehri Salari2, Shahedeh Karimi3, Massoud Vosough3, Amirhossein Memari1, Seyed Massood Nabavi3*

In spite of the observed immunomodulatory properties of different sex hormones on Multiple Sclerosis (MS) in different investigations, to date, there has been no study to systematically review the documents to add more powerful data to the field. Therefore, in this paper we aim to systematically review clinical and Randomized Controlled Trials (RCT) assessing the effect of sex hormone therapies on individuals with MS. A comprehensive search of electronic databases including PubMed, EMBASE, and Scopus was conducted. Clinical trials and RCTs that assessed the impact of sex hormones on individuals with MS were selected and included in the systematic review. In the final phase of the search strategy, 9 papers reached the criteria for entering in the systematic review. Two independent reviewers extracted the relevant data from each article according to the standardized data extraction form. Two reviewers also assessed the quality of each study independently using PEDro scale. We categorized three different classifications of outcomes including clinical, MRI, and immune system findings and put each measured outcome in the category which matched best. In conclusion, the existed investigations on the effect of sex hormones on inflammatory and neurodegenerative components of MS are promising particularly in Relapsing-Remitting MS (RRMS).