Data abstraction
The titles and abstracts of studies retrieved during the searches were
screened for duplicates by two independent reviewers (PB and PW).
Potentially relevant full-texts were then screened according to our
inclusion and exclusion criteria. The final included studies were then
collated, and the two reviewers used standardized data extraction
formats to extract the data. After extraction, both reviewers matched
their data with each other and revisited papers where disagreements
arose. Any discrepancies were resolved through discussion with other
team members. The extracted data included the following: first author,
study design, site of study, year of publication, language, number of
patients receiving fingolimod, the values of variables If required data
was missing, not reported in the paper, or reported in an unusual form,
the corresponding authors of the respective papers were contacted for
clarification. Supplementary material associated with the main paper was
also explored in such cases.
Risk of Bias Assessment and Quality of
Evidence
Two authors (PB and PW)individually assessed the methodological quality
of RCTs using the Cochrane Collaboration tool for assessing the risk of
bias. (23) (24)The criteria were selected a priori and included: (1)
random sequence generation, (2) allocation concealment, (3) blinding of
participants, (4) blinding of outcome assessment, (5) incomplete outcome
data, (6) selective reporting(including reporting of all outcomes and
specifying a primary outcome), and (7) other bias. The evaluated domains
were judged as low risk, high risk, or unclear bias per established
criteria. In the case of evaluation discrepancies, the authors discussed
and came to an agreement.