用于复发性复发性多发性硬化症的二甲基酸盐或二甲基酸盐:营销后研究的元分析
Luca Prosperini1, Shalom Haggiag2, Serena Ruggieri3,4
1Department of Neurology, San Camillo-Forlanini Hospital, C.ne Gianicolense 87, 00152, Rome, Italy. luca.prosperini@gmail.com.
概括
在多发性硬化症中,二甲基烟酸 (DMF) 略有降低了复发风险,比特里弗卢诺米德 (TRF) 更多. 然而,TRF显示由于副作用而导致更低的中止率,这表明复发性复发性多发性硬化症的个性化治疗选择.
科学领域:
- 神经学 神经学
- 药理学 药理学是指药理学的学科.
- 临床试验 临床试验
背景情况:
- 复发性复发性多发性硬化症 (RRMS) 是一种慢性自身免疫性疾病.
- 丁甲基 fumarate (DMF) 和 teriflunomide (TRF) 是通常用于RRMS的口服疾病修饰治疗 (DMT).
- 缺乏将DMF和TRF进行对比的对头试验,需要现实世界的证据综合.
研究的目的:
- 在RRMS患者中比较DMF与TRF的实际有效性和安全性.
- 为了评估复发风险,确认残疾恶化 (CDW) 和治疗中止率的差异.
- 确定治疗差异可能更明显的患者子组.
主要方法:
- 一个系统的文献搜索发现了现实世界的研究直接比较DMF和TRF.
- 使用随机效应模型的反变量加权元分析.
- 评估的结果包括复发风险比率 (RR),CDW和停止治疗.
主要成果:
- 与TRF相比,DMF显示了短期复发风险的统计学上显著,尽管很小,但降低了 (RR=0.92,p=0.01).
- 在DMF和TRF之间没有观察到关于CDW短期风险的显著差异 (RR=0.99,p=0.69).
- 治疗中止率总体上相似,但由于副作用和不良事件,TRF的发生率较低.
结论:
- 与RRMS的TRF相比,DMF在减少复发方面可能具有轻微的优势.
- 在较年轻,未经治疗的患者中,治疗差异似乎不那么明显.
- 当减少因副作用而停止治疗是优先事项时,可能会优先选择特里弗卢诺胺 (TRF).
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