在复发性复发性多发性硬化症中,Rituximab与Ocrelizumab对比
Izanne Roos1,2, Stella Hughes3, Gavin McDonnell4
1Neuroimmunology Centre, Royal Melbourne Hospital, Melbourne, Victoria, Australia.
JAMA neurology
|June 12, 2023
概括
利图西马布在治疗复发性复发性多发性硬化症 (MS) 中不如奥克雷利祖马布那么有效. 这项研究发现,在现实世界MS治疗中,与ocrelizumab相比,rituximab与复发的风险更高有关.
科学领域:
- 神经免疫学 神经免疫学
- 药理学 药理学是指药理学的学科.
背景情况:
- 奥克雷利祖马布有效地减少复发性复发性复发性多发性硬化症 (MS) 的复发和残疾恶化.
- 抗CD20药物利图西马布 (Rituximab) 经常被非标签使用,作为ocrelizumab的替代品,用于MS治疗.
研究的目的:
- 确定rituximab在治疗复发性缓解性多发性硬化症时是否与ocrelizumab不逊色.
- 在现实环境中比较rituximab与ocrelizumab的有效性.
主要方法:
- 一项观察性队列研究,利用2015年1月至2021年3月期间的MSBase和丹麦MS注册表 (DMSR) 的数据.
- 倾向性得分匹配用于比较用ocrelizumab或rituximab治疗的患者,控制基线特征.
- 年化复发率 (ARRs) 是主要结果,其非劣势率为1.63.
主要成果:
- 这项研究包括1613名患有复发性复发性多发性硬化症的患者 (710名接受了ocrelizumab,186名接受了rituximab) 在倾向性得分匹配后.
- 与ocrelizumab相比,rituximab治疗与每年复发率显著增加有关 (比率比,1.8;P<.001).
- 在两个治疗组之间,在6个月内确认残疾累积的风险上没有发现显著差异.
结论:
- 在这项比较有效性研究中,利图西马布没有证明与ocrelizumab的非劣势性.
- 在临床实践中,Rituximab似乎与MS治疗中的ocrelizumab相比,复发的风险更高.
- 随机试验的进一步评估是有必要的,以确认Rituximab和ocrelizumab在标准化剂量和间隔的疗效.
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