利图西马布的有效性突发性B细胞重组在多发性硬化症:时间重新考虑剂量?
Roxane Claverie1, Marine Perriguey1, Audrey Rico1
1From the Department of Neurology (B.A., M.P., A.R., C.B., S.D., F.H., J.P., A.M.), CRMBM, University Hospital of Marseille, Aix-Marseille University; Service d'immunologie (D.C., F.V.), Marseille Immunopôle, APHM, Aix Marseille University, CNRS, INSERM, CIML; Faculté de Pharmacie (R.C.), Aix-Marseille University; and Centre hospitalier d'Ajaccio (P.D.), Service de Neurologie, France.
在多发性硬化症 (MS) 中,延长剂量利图西马布 (RTX) 是安全有效的,即使在B细胞复制. 这种方法可以降低感染风险,并改善MS患者的疫苗反应.
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.
- 临床医学 临床医学
背景情况:
- 接受Rituximab (RTX) 治疗的多发性硬化症 (PwMS) 患者在延长剂量间隔后显示持续有效.
- 循环B细胞的深度耗尽可能不必维持RTX在MS中的有效性.
研究的目的:
- 在PwMS中评估延长RTX剂量间隔 (长达24个月) 的安全性和有效性.
- 在第一个延长的剂量间隔期间分析B细胞子集复制和疾病活性.
主要方法:
- 对2019年后连续PwMS启动或继续RTX的前性,单心观测研究.
- 系统监测循环B细胞子集和复发率.
- 在延长剂量间隔期间分析MRI活性和临床复发.
主要成果:
- 包括236个PwMS;中位数RTX剂量延迟时间为17个月.
- 平均每年复发率在 (0.03) 之前和 (0.04) RTX剂量延长后 (p=0.51) 保持相似.
- 97%的患者没有出现新的MRI病变; 5人经历了复发,B细胞复合水平没有差异.
结论:
- 尽管有大量的B细胞复制,但RTX的疗效仍然存在,这表明免疫系统的更新时间长.
- 延长RTX剂量在PwMS中是安全的,可能会降低感染风险并提高疫苗的疗效.
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