转换为二线多发性硬化症疾病修饰疗法与复发率降低有关
James John Marriott1, Okechukwu Ekuma2, Randall Fransoo3
1Division of Neurology, Department of Medicine, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada.
Frontiers in neurology
|September 25, 2023
概括
现实世界多发性硬化症 (MS) 治疗有效性表明,切换DMT可以增加复发风险. 然而,切换到二线疗法与复发发生之前的时间更长有关.
科学领域:
- 神经学 神经学
- 现实世界的证据.
- 多发性硬化症的治疗方法
背景情况:
- 随机对照试验 (RCT) 评估治疗的疗效,而不是现实世界的有效性.
- 了解影响多发性硬化症 (MS) 复发风险的因素在常规护理中至关重要.
研究的目的:
- 评估人口结构和疾病修饰疗法 (DMT) 暴露,包括坚持和切换,如何影响后续多发性硬化症复发风险.
主要方法:
- 在曼尼托巴省 (1999-2014) 复发性多发性硬化症患者的回顾性队列研究,使用医疗保健数据库.
- 分析了DMT使用,坚持 (CUMMPRs) 和切换.
- 经对共变量调整后的逻辑学和考克斯回归模型评估了第一次治疗复发的时间.
主要成果:
- 总的DMT暴露与复发时间没有相关性.
- 超过两次切换DMT与切换后复发率的增加有关.
- 与保持一线治疗相比,切换到二线DMT显著降低了复发风险 (HR 0.44).
结论:
- 转换为高效的DMT可以降低人口层面的MS复发率.
- 治疗策略应考虑DMT切换对复发风险的影响.
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