二次渐进性多发性硬化症的风险在地理上决定,但可以修改
Sifat Sharmin1,2, Izanne Roos1,2, Steve Simpson-Yap1,3,4
1CORe, Department of Medicine, University of Melbourne, Melbourne 3050, Australia.
Brain : a journal of neurology
|June 27, 2023
概括
较高的度增加了患二级渐进性多发性硬化症 (SPMS) 的风险. 有效的免疫疗法可以降低这种风险,减轻对SPMS进展的地理影响.
科学领域:
- 神经学 神经学
- 流行病学 流行病学
- 环境健康 环境健康
背景情况:
- 多发性硬化症 (MS) 发病率和患病率的地理差异已得到充分证实.
- 度,紫外线辐射和其他环境因素都与MS风险有关.
- 此前没有研究过二次渐进性多发性硬化症 (SPMS) 风险的地理差异.
研究的目的:
- 评估复发性复发性多发性硬化症 (RRMS) 患者中SPMS风险的地理差异.
- 评估度和居住国对SPMS风险的影响.
- 为了确定高到中等疗效的免疫疗法是否会改变度对SPMS风险的影响.
主要方法:
- 来自全球MSBase注册表的51,126名RRMS患者的地理多样性队列的分析.
- 利用临床医生诊断的SPMS,并进行了使用操作化的定义进行敏感性分析.
- 采用比例危险模型来估计SPMS风险,调整多个共变量并纳入空间相关的脆弱性.
主要成果:
- 更高的度,更高的国家MS患病率,男性性别,更高的发病年龄,更高的残疾和频繁的复发与增加的SPMS风险有关.
- 高到中等效率的免疫疗法显著降低了SPMS风险 (危险比0.76).
- 宽度对SPMS风险的影响通过免疫疗法减少 (相互作用危险比率为0.95).
结论:
- 更高的度与发展SPMS的可能性更大有关.
- 高到中等效的免疫疗法可以减轻SPMS的地理影响风险.
- 了解地理风险因素对于个性化MS管理至关重要.
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