免疫療法と再発性寛解性多発性硬化症における結果との関連
Irene Tramacere1, Cinzia Del Giovane2, Graziella Filippini3
1Neuroepidemiology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
JAMA
|January 28, 2016
まとめ
アレムツズマブ,ナタリズマブ,フィンゴリモドは,再発性寛解性多発性硬化症の有意な再発予防効果を提供します. しかし,フェンゴリモドは副作用により治療中止のリスクが高い.
科学分野:
- 神経科学
- 免疫学
- 薬理学について
背景:
- 多発性硬化症 (MS) は,中枢神経系に影響を与える慢性的な自己免疫疾患です.
- 再発性寛解性MS (再発性寛解性MS) は最も一般的な形態で, 明確な発作と寛解が特徴です.
- 免疫療法はRRMSの管理に不可欠ですが,その比較的な利益とリスクは明確にする必要があります.
研究 の 目的:
- 再発性寛解性多発性硬化症に対する様々な免疫療法の利点とリスクを評価する.
- どの免疫療法が再発予防に最も効果的かを特定する.
- これらの治療法に関連した有害事象による治療中止のリスクを決定する.
主な方法:
- RRMSに対する免疫療法を比較した臨床試験の体系的レビューとメタ分析.
- 再発と障害の悪化を防ぐ効果の評価
- 副作用の概要と治療中断率の分析
主要な成果:
- アレムツズマブ,ナタリズマブ,フィンゴリモドは再発を予防する上で最大の効果を示した.
- 障害の悪化を防ぐためのこれらの治療法の影響は不明である.
- フェンゴリモドは,有害事象による治療中断率が高いと関連付けられました.
結論:
- アレムツズマブ,ナタリズマブ,フィンゴリモードはRRMSの再発予防に非常に有効です.
- 障害の進行への影響を明らかにするためにさらなる研究が必要である.
- フィンゴリモドの有害事象プロファイルは,患者の注意深いモニタリングと中止の検討を必要とします.
関連する概念動画
Tumor Immunotherapy
2.2K
Immunotherapy is a treatment that boosts or manipulates the immune system to fight diseases, including cancer. For instance, by stimulating an immune response through vaccinations against viruses that cause cancers, like hepatitis B virus and human papillomavirus, these diseases can be prevented. Nonetheless, some cancer cells can avoid the immune system due to their rapid mutation and division. The immune response to many cancers involves three phases: elimination, equilibrium, and escape.
2.2K
Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
659
Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
659
Combination Therapies and Personalized Medicine
6.3K
Combining two or more treatment methods increases the life span of cancer patients while reducing damage to vital organs or tissue from the overuse of a single treatment. Combination therapy also targets different cancer-inducing pathways, thus reducing the chances of developing resistance to treatment.
The combination of the drug acetazolamide and sulforaphane is a good example of combination therapy to treat cancer. The cells in the interior of a large tumor often die due to the hypoxic and...
The combination of the drug acetazolamide and sulforaphane is a good example of combination therapy to treat cancer. The cells in the interior of a large tumor often die due to the hypoxic and...
6.3K
Combination Therapies and Personalized Medicine
1.8K
1.8K
Treatment Resistant Cancers
3.9K
Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...
3.9K
Treatment Resistent Cancers
1.5K
1.5K


