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Las interferones en la esclerosis múltiple recidivante remitente: una revisión sistemática.

Graziella Filippini1, Luca Munari, Barbara Incorvaia

  • 1Unità di Neuroepidemiologia, Istituto Nazionale Neurologico C Besta, Milan, Italy. gfilippini@istituto-besta.it

Lancet (London, England)
|February 25, 2003
PubMed
Resumen
Este resumen es generado por máquina.

Los interferones recombinantes pueden reducir ligeramente las exacerbaciones recurrentes remitentes de la esclerosis múltiple en el primer año. La eficacia a largo plazo y los efectos secundarios de estos tratamientos de EM requieren una mayor investigación en nuevos ensayos clínicos.

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Área de la Ciencia:

  • Neurología Neurología.
  • Inmunología Inmunología.
  • Farmacología Farmacología.

Sus antecedentes:

  • Los interferones recombinantes están aprobados para la esclerosis múltiple con remisión recurrente (EMRR).
  • Existe un debate en curso con respecto a su efectividad, beneficios, efectos secundarios y costos en la gestión de RRMS.
  • La síntesis de la evidencia es crucial para la toma de decisiones clínicas informadas en el tratamiento de RRMS.

Objetivo del estudio:

  • Evaluar la eficacia de las interferonas recombinantes en el tratamiento del EMRR.
  • Para determinar si las interferonas recombinantes reducen las exacerbaciones clínicas y la progresión de la enfermedad en comparación con el placebo.
  • Evaluar el impacto de las interferonas recombinantes en el uso de esteroides y los ingresos hospitalarios en pacientes con EMRR.

Principales métodos:

  • Revisión sistemática de ensayos aleatorizados, controlados con placebo (1993-2002) utilizando la metodología de la Colaboración Cochrane.
  • Se incluyeron 1215 pacientes con EMRRR tratados con interferones recombinantes.
  • Se analizaron datos sobre exacerbaciones, progresión de la enfermedad, uso de esteroides, ingresos hospitalarios y resultados de resonancia magnética.

Principales resultados:

  • El interferón mostró una tendencia a reducir las exacerbaciones en el primer año (RR 0.73).
  • Los resultados a los 2 años no fueron concluyentes debido a los abandonos y los análisis de sensibilidad.
  • Efectos secundarios comunes afectaron negativamente la calidad de vida de los pacientes; datos insuficientes sobre el uso de esteroides, los ingresos hospitalarios y los resultados de la resonancia magnética.

Conclusiones:

  • Las interferonas recombinantes ofrecen una ligera reducción de las exacerbaciones durante el primer año de tratamiento con EMRR.
  • La eficacia clínica a largo plazo de estas terapias de EM sigue siendo incierta.
  • Se necesitan más ensayos para evaluar completamente la eficacia a largo plazo y el perfil de seguridad de las interferonas recombinantes en RRMS.