OBJECTIVES:

Traditional network meta-analysis (NMA) methods are time-consuming, requiring extensive data preparation and knowledge of statistical programming. A living NMA tool presents an opportunity to recreate existing NMAs, monitor new evidence and quickly update analyses within a few minutes. In this study, we replicated and updated an existing NMA using an interactive NMA tool.

METHODS:

Leveraging an existing living systematic literature review (SLR) platform, which is regularly updated to capture newly published articles and abstracts, we developed an integrated living NMA tool. To validate this tool, an existing NMA of progression free survival (PFS) with multiple myeloma maintenance regimens by Luchinin et al. was replicated. The network consisted of 13 trials, including MRC-Myeloma IX, HOVON65, IFM2005-02, GEM2005, NCT01063179, NCT00551928, NCT01091831, CALGB, MyelomaXI, Tourmaline-MM3, ALCYONE, FIRST, and MAIA. Included trials involved 10 treatment regimens: lenalidomide, lenalidomide-prednisone, lenalidomide-dexamethasone, thalidomide, bortezomib, bortezomib-thalidomide, bortezomib-prednisone, ixazomib, daratumumab-lenalidomide-dexamethasone, and daratumumab. The replicated NMA was subsequently updated with a recently published study, comparing carfilzomib-lenalidomide-dexamethasone (KRD) with lenalidomide.

RESULTS:

By combining our living SLR and NMA platforms, we replicated the reference network diagram and treatment hierarchy within 2 minutes. Data from one study was not accessible. Both networks were structurally similar and treatment ranking was comparable. Indirect comparisons between daratumumab-lenalidomide-dexamethasone, lenalidomide-prednisolone and bortezomib, respectively, versus observation were successfully implemented. The NMA update was rapid and showed KRD to have the best improvement in PFS compared with the other regimens in the model.

CONCLUSIONS:

This study demonstrated the utility of an interactive NMA tool, which replicated and updated an existing analysis in a few minutes. This reliable tool can help decision makers stay current with comparative effectiveness of new and existing treatments.