在高度残疾的渐进性多发性硬化症患者中使用ocrelizumab
Maria Houtchens1, Danielle Howard1
1Neurology Department, Brigham and Women's Hospital, 60 Fenwood Rd, Boston, MA 02115, USA.
Multiple sclerosis and related disorders
|January 5, 2024
概括
在高度残疾的多发性硬化症 (MS) 患者中,ocrelizumab可能会稳定疾病,但仔细考虑副作用至关重要. 这项研究评估了其在现实世界中的使用和该人群中的结果.
科学领域:
- 神经学 神经学
- 免疫学 免疫学 免疫学
- 临床治疗学 临床治疗学
背景情况:
- 作为一种抗CD20单克隆抗体的ocrelizumab已被批准用于复发性复发性硬化症 (RRMS) 和初级渐进性多发性硬化症 (PPMS).
- 在最初的试验中被排除在外的高度残疾的MS患者 (EDSS ≥6.5) 中使用ocrelizumab的现实数据有限.
- 高水平的残疾可能会成为获得治疗的障碍,需要特别考虑安全性和有效性.
研究的目的:
- 评估ocrelizumab在患有严重运动残疾的多发性硬化症患者的实际可访问性,耐受性和治疗结果.
- 在这个未经研究的患者群体中描述副作用概况,治疗持久性和疾病稳定性.
主要方法:
- 扩大残疾状况尺度 (EDSS) 6.5 或更高的患者开始使用ocrelizumab的回顾性审查.
- 排除标准包括最近使用Rituximab,同时服用免疫抑制剂或替代诊断.
- 收集了关于不良事件,治疗持续时间 (>1年) 和MS疾病活性 (稳定与进展) 的数据.
主要成果:
- 62名高度残疾的MS患者 (EDSS中位数7.0) 被纳入分析.
- 超过一半 (51.6%) 继续服用ocrelizumab,平均为36.5个月;46.8%的人停止治疗,主要是由于副作用或缺乏益处.
- 在66.1%的患者中观察到疾病稳定,其中29.0%报告主观稳定,而25.8%的患者经历了残疾恶化.
结论:
- 奥克雷利祖马布可以在高度残疾的多发性硬化症患者的子组中实现疾病稳定.
- 由于这种高风险人群中可能出现不良事件,因此需要仔细评估风险和益处.
- 需要进行进一步的研究,以优化晚期残疾多发性硬化症患者的治疗策略.
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