免疫疗法与复发性复发性硬化症的结果的关联
Irene Tramacere1, Cinzia Del Giovane2, Graziella Filippini3
1Neuroepidemiology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
JAMA
|January 28, 2016
概括
在复发性缓解性多发性硬化症中,阿勒姆图祖马布,纳塔利祖马布和芬戈利莫德具有显著的预防益处. 然而,由于不良事件,fingolimod 具有中止治疗的高风险.
科学领域:
- 神经学
- 免疫学
- 药理学
背景情况:
- 多发性硬化 (MS) 是一种影响中枢神经系统的慢性自身免疫性疾病.
- 复发性复发性多发性硬化 (RRMS) 是最常见的形式,其特征是明显的发作和缓解.
- 免疫疗法对于治疗RRMS至关重要,但它们的比较好处和风险需要澄清.
研究的目的:
- 对复发性缓解性多发性硬化症的不同免疫疗法的益处和风险进行评估.
- 确定哪些免疫疗法提供了最大的复发预防.
- 确定因这些治疗相关的不良事件而导致治疗中止的风险.
主要方法:
- 对RRMS免疫疗法进行比较的临床试验的系统审查和元分析.
- 对预防复发和残疾恶化的疗效进行评估.
- 对不良事件概况和治疗中止率的分析.
主要成果:
- 在预防复发方面,阿拉姆图祖马布,纳塔利祖马布和芬戈利莫德的效果最大.
- 这些疗法对预防残疾恶化的影响尚不清楚.
- 由于不良事件,芬戈利莫德治疗中断率很高.
结论:
- 阿拉姆图祖马布,纳塔利祖马布和芬戈利莫德是预防RRMS复发的高度有效的药物.
- 需要进一步研究以澄清它们对残疾进展的影响.
- 需要对患者进行仔细的监测,并考虑是否停止使用Fingolimod.
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