在意大利三个地区的肌缩性侧面硬化症患者中坚持理卢治疗 - - CAESAR研究
Sabrina Giometto1, Marco Finocchietti2, Olga Paoletti3
1Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
Pharmacoepidemiology and drug safety
|November 28, 2023
概括
大多数肌缩侧面硬化症 (ALS) 患者在第一年坚持使用瑞卢治疗. 早期停止理卢的治疗与患者脆弱性和死亡率的增加有关.
科学领域:
- 神经学 神经学
- 药理学 药理学是指药理学的学科.
- 公共卫生 公共卫生
背景情况:
- 肌缩侧面硬化症 (ALS) 是一种罕见的神经退行性疾病.
- 利鲁是ALS的关键药物,可能改善存活率并延迟机械通风.
- 该CAESAR项目旨在评估药物处方模式,有效性和罕见神经退行性疾病的安全性.
研究的目的:
- 评估ALS患者在治疗第一年期间对riluzole的坚持.
- 为了识别不同类型的riluzole粘附模式的集群.
- 分析与不同粘附轨迹相关的因素.
主要方法:
- 使用意大利三个地区 (拉蒂乌姆,托斯卡纳,乌姆布里亚) 的行政数据进行了回顾性队列研究.
- 包括在2014-2019年期间诊断出新的ALS患者,在诊断后180天内给予瑞卢.
- 使用修改的药物占有率和集群分析计算每月的坚持,以确定坚持轨迹.
主要成果:
- 确定了两个坚持群体:坚持患者 (60-88%) 和停止治疗的患者 (12-40%).
- 在托斯卡纳,停止服用瑞卢的患者的死亡率明显高 (28.6%与15.4%相比).
- 较低的坚持与中枢神经系统疾病的增加以及更多地使用诸如侵入性通风等非药物治疗方法有关.
结论:
- 大多数ALS患者在治疗的第一年开始并维持理卢治疗.
- 早期停止使用瑞卢的患者死亡率更高,疾病负担更大.
- 对riluzole的坚持是影响ALS患者结果的关键因素.
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