To the Editor: We recently became aware of the study by Chen et al. Notable differences in the 3-month confirmed disability progression (CDP3M) outcome in this analysis have been identified compared with previously published network meta-analysis (NMA). More specifically, the results for CDP3M greatly differ for interferon (IFN) beta-1A 30 mcg every week, IFN beta-1A 44 mcg 3 times a week, IFN beta-1A 22 mcg 3 times a week, natalizumab 300 mg every 4 weeks, and ocrelizumab 600 mg every 24 weeks. The published comparative estimates by Chen et al. may compromise the external validity of the SUCRA ranking results given that it is inconsistent with the totality of the existing body of published evidence. For example, the NMA of Chen et al. includes only one trial assessing the efficacy of natalizumab (where it was compared with placebo). Because there are no trials comparing natalizumab with other active treatments, the pooled effect estimate for natalizumab versus placebo (hazard ratio = 0.85) should remain similar to the treatment effect estimate from the original trial (hazard ratio = 0.58). However, this is not the case in the review of Chen et al. Similar discrepancies appear for ponesimod where the original trial reported a hazard ratio versus teriflunomide 14 mg of 0.83 (0.58; 1.18), whereas the NMA reported a hazard ratio of 1.39 (0.55; 3.57). Therefore, we respectfully request additional transparency from Chen et al. regarding the NMA methods and additional clarity supporting their results.