克拉德里宾片与芬戈利莫德在高度活跃的多发性硬化症治疗中的比较有效性:现实世界的研究
Wallace J Brownlee1, Aiden Haghikia2, Brooke Hayward3
1Queen Square MS Centre, University College London Institute of Neurology and National Institute for Health and Care Research (NIHR) University College London Hospitals Biomedical Research Centre, London, UK.
Multiple sclerosis and related disorders
|June 21, 2023
概括
克拉德里宾片对治疗高度活跃复发性多发性硬化症 (HA-RMS) 的治疗效果与芬戈利莫德无差. 现实数据显示,在12个月内降低复发率的效果相似.
科学领域:
- 神经学 神经学
- 免疫学 免疫学 免疫学
- 药理学 药理学是指药理学的学科.
背景情况:
- 克拉德里宾片和fingolimod已在欧洲批准用于高度活性复发性多发性硬化症 (HA-RMS).
- 缺乏直接的比较研究,需要现实世界的数据来评估有效性.
- 口服疾病修饰疗法 (DMT) 为MS患者提供了方便的治疗选择.
研究的目的:
- 在HA-RMS患者中比较cladribine片和fingolimod之间的复发率.
- 在现实环境中评估克拉德里宾片与芬戈利莫德的非劣势.
- 在HA-RMS管理中提供治疗决策的证据.
主要方法:
- 英国和德国的多中心回顾性研究.
- 在HA-RMS患者中12个月的复发率相比,开始服用克拉迪片或fingolimod.
- 使用倾向性得分分析与治疗权重的逆概率.
主要成果:
- 包括1,095名HA-RMS患者:610人服用克拉迪宾片,485人服用fingolimod.
- 调整后的年化复发率 (ARR) 为克拉德里宾片的0.10,而fingolimod的0.14.
- 克拉迪布林片与芬戈利莫德没有劣势 (ARR比0.68;95%CI:0.42-1.11).
结论:
- 克拉迪布林片在一年后表现出与芬戈利莫德 (fingolimod) 相似的有效性.
- 与克拉德里宾片一起观察到的更低的停止/切换率.
- 结果可能是保守的,因为cladribine治疗在两年内完成.
相关概念视频
Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids
161
Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
161
Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
202
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...
202
Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF
177
Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab...
177
Parkinson's Disease: Treatment
303
Neurodegenerative disorders, such as Parkinson's Disease (PD), involve the gradual and irreversible destruction of neurons in particular brain areas. These disorders exhibit standard features like proteinopathies, selective vulnerability of some neurons, and an interaction of intrinsic properties, genetics, and environmental influences in neural injury.
Parkinson's Disease is primarily a result of the loss of dopaminergic neurons in the substantia nigra pars compacta. The cornerstone of...
Parkinson's Disease is primarily a result of the loss of dopaminergic neurons in the substantia nigra pars compacta. The cornerstone of...
303
Myasthenia Gravis: Overview and Treatment
1.6K
Myasthenia gravis is a neuromuscular transmission disorder characterized by weakness and increased fatigability of skeletal muscles. It is an autoimmune disease affecting approximately one in 2000 people, where antibodies against the α1 subunit of nicotinic acetylcholine receptors are produced.
These antibodies interfere with the function of the nicotinic receptors in three ways: by binding to the receptor and disrupting acetylcholine binding; by causing cross-linking of receptors which...
These antibodies interfere with the function of the nicotinic receptors in three ways: by binding to the receptor and disrupting acetylcholine binding; by causing cross-linking of receptors which...
1.6K
Drugs for Treatment of Ulcerative Colitis in IBD
179
Ulcerative colitis is a chronic inflammatory condition primarily affecting the colon and rectum. The primary drugs used in the treatment of ulcerative colitis are aminosalicylates. They exhibit anti-inflammatory and immunosuppressive properties. They modulate inflammatory mediators and inhibit the activity of nuclear factor κB (NF-κB). Aminosalicylates also reduce inflammation by inhibiting prostaglandin and leukotriene production and decreasing neutrophil chemotaxis and superoxide...
179


