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Winston Dzau^1,2, Sifat Sharmin², Francesco Patti^3,4

¹Neuroimmunology Centre, Department of Neurology, The Royal Melbourne Hospital, Parkville, Victoria, Australia.

Journal of neurology, neurosurgery, and psychiatry

|July 6, 2023

概括

在早期多发性硬化症 (MS) 中,不依赖复发活动的进展 (PIRA) 和复发相关恶化 (RAW) 会增加二次渐进性MS (SPMS) 的风险. 早期治疗可以缓解复发相关的恶化,但不能减轻SPMS发展中的PIRA.

科学领域:

神经学神经学
免疫学免疫学免疫学
临床研究临床研究

背景情况:

二次渐进性多发性硬化症 (SPMS) 的特征是持续的神经衰退.
在过渡到SPMS时,不依赖复发活动的进展 (PIRA) 和复发相关恶化 (RAW) 的作用尚未完全理解.
调查SPMS的早期指标对于及时干预至关重要.

研究的目的:

为了确定早期PIRA和RAW是否预测SPMS的早期发病.
评估早期PIRA/RAW与SPMS中随后残疾累积之间的关联.
评估早期疾病修饰疗法 (DMT) 暴露对SPMS风险的影响.

主要方法:

来自国际MSBase注册表的10692名复发性复发性多发性硬化症 (RRMS) 患者的观察队列研究.
早期PIRA和RAW (多发性硬化症前5年) 的分析,使用考克斯比例危险模型对时间到SPMS进行分析.
用多变量线性回归来分析SPMS期间残疾进展.

主要成果:

在早期多发性硬化时,较高的PIRA和RAW显著与患上SPMS的风险增加有关.
早期的DMT暴露降低了与RAW相关的SPMS风险,但不是PIRA.
在早期PIRA/RAW和在已确定的SPMS期间残疾进展率之间没有发现任何关联.

结论:

在RRMS期间,无论是PIRA还是RAW,早期残疾增加与过渡到SPMS的风险更高有关.
与复发相关的恶化是SPMS的潜在可治疗的风险因素.
对SPMS发作的PIRA的贡献可能独立于早期治疗干预.

关键词:

多发性硬化多发性硬化

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