早期多发性硬化症中亚临床疾病活动的识别和管理:一篇综述
Daniel Ontaneda1, Tanuja Chitnis2, Kottil Rammohan3
1Mellen Center for Multiple Sclerosis, Department of Neurology, Cleveland Clinic, Cleveland, OH, USA. ontaned@ccf.org.
Journal of neurology
|October 21, 2023
概括
多发性硬化症 (MS) 的早期治疗至关重要. 除了复发和MRI扫描之外,识别隐藏的疾病指标可以改善管理和预防残疾.
科学领域:
- 神经学 神经学
- 免疫学 免疫学 免疫学
背景情况:
- 在多发性硬化症 (MS) 早期开始治疗对于预防不可逆转的神经损伤和残疾至关重要.
- 目前的MS疾病活动评估依赖于复发率和MRI病变活动,可能缺少早期指标.
- 隐藏的指标,如认知障碍和疲劳,在常规监测中经常被忽视.
研究的目的:
- 为了突出当前多发性硬化病活动监测的局限性.
- 倡导将"隐藏"指标纳入多发性硬化症评估中.
- 强调需要修订多发性硬化症管理策略,包括及时的治疗干预.
主要方法:
- 审查目前在多发性硬化症疾病活动监测的实践.
- 讨论除了复发和MRI之外的MS疾病活动的早期指标.
- 分析无声进展及其对患者结果的影响.
主要成果:
- 标准的MS监测可能无法检测到"无声进展"或恶化的疾病.
- 患者可能被认为是稳定的,尽管潜在的疾病活动.
- 观察性研究表明,早期高效疗法 (HET) 可以减少残疾的进展.
结论:
- 迫切需要重新评估多发性硬化病的活动和恶化的测量.
- 纳入"隐藏"指标和生物标志物可以提供一个更全面的MS的图片.
- 用HET或DMT调整及时进行治疗干预对于最佳患者结果至关重要.
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