停止使用芬戈利莫德后反弹的频率和风险因素 - 一项回顾性研究
A Maunula1, S Atula2, S M Laakso3
1Translational Immunology Research Program, University of Helsinki, Helsinki, Finland; HUS Brain Center, Department of Neurology, Hyvinkää Hospital, Hyvinkää, Finland.
Multiple sclerosis and related disorders
|November 19, 2023
概括
芬戈利莫德 (FTY) 反弹,在停止使用药物后严重复发,发生在10.5%的患者中. 年龄较小,FTY使用时间较长,以及停药后淋巴细胞数量较低是危险因素.
科学领域:
- 神经学 神经学
- 免疫学 免疫学 免疫学
- 药理学 药理学是指药理学的学科.
背景情况:
- 芬戈利莫德 (FTY) 反弹,以停止后的严重疾病活动为特征,影响5-43%的患者.
- 对于FTY反弹存在有限的大规模队列分析.
- 这项研究调查了芬兰南部的FTY反弹频率和风险因素.
研究的目的:
- 为了确定FTY反弹在大量人群中的发生率.
- 确定与FTY反弹相关的临床和免疫风险因素.
- 将反弹特征与FTY停止后的普通复发进行比较.
主要方法:
- 对芬兰MS-register对使用FTY超过6个月的患者进行回顾性分析.
- 医疗记录审查以收集人口统计数据并评估复发标准.
- 定义的反弹是严重的复发 (≥2 EDSS点的增加) 或在FTY停止后6个月内多次复发.
主要成果:
- 在283名FTY用户中,分析了114次停产;10.5%的用户经历了反弹.
- 复发患者在诊断时年轻,与非复发组相比,FTY暴露时间更长.
- 停药后较低的淋巴细胞数量和较高的中性粒细胞与淋巴细胞比率 (NLR) 与反弹有关.
结论:
- FTY反弹发生在10.5%的患者中,与现有文献一致.
- 在FTY停止后,迅速启动后续疾病修饰疗法至关重要.
- 诊断时年轻的年龄,更长时间的FTY暴露,较低的淋巴细胞和较高的NLR是已识别的反弹风险因素,表明有不同的病理生理学.
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