复发性复发性多发性硬化症的替代剂量fingolimod:一个系统的审查
Fereshteh Ghadiri1, Omid Mirmosayyeb2, Mohammad Ali Sahraian1
1Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
Current journal of neurology
|November 27, 2023
概括
在复发性复发性多发性硬化症患者出现不良事件时,替代日用fingolimod可能是一种安全有效的策略. 然而,证据仍然模两可,存在疾病重新激活的风险. 需要进一步的研究.
科学领域:
- 神经学 神经学
- 药理学 药理学是指药理学的学科.
背景情况:
- 芬戈利莫德是复发性复发性多发性硬化症 (RRMS) 的标准治疗方法,每天服用0.5毫克.
- 临床医生有时会降低fingolimod的剂量,特别是替代日疗法,以管理不良事件.
- 本综述侧重于替代性日用fingolimod剂量的疗效和安全性.
研究的目的:
- 系统地审查有关替换日fingolimod剂量的疗效的文献.
- 评估减少fingolimod剂量策略的安全性和有效性.
主要方法:
- 在主要数据库 (PubMed,科学网,Embase,Scopus,Cochrane图书馆) 进行了系统的文献搜索,直到2021年4月9日.
- 包括英语的临床研究 (不包括病例报告/病例系列),特别关注交替日或更少频繁的剂量 (不减少每日剂量).
- 分析了四项观察性研究,其中三项被评为质量良好.
主要成果:
- 包括四项观察性研究,涉及296名患者接受标准剂量和276名患者接受替代剂量.
- 转换为替代剂量的常见原因是淋巴缺血和肝酶升高.
- 两项研究表明,替代剂量对于控制不良反应是安全有效的,而一项研究则警告潜在的疾病重新激活.
结论:
- 目前关于替代日fingolimod剂量的安全性和有效性的证据是模两可的.
- 审查强调需要进一步研究,以澄清替代剂量在RRMS管理中的作用.
- 潜在的风险,如疾病的重新激活,需要仔细考虑.
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