停止使用fingolimod时T2病变的风险:全国性的预测和比较研究
Malthe Faurschou Wandall-Holm1, Rolf Pringler Holm1, Alex Heick2
1Department of Neurology, Danish Multiple Sclerosis Registry, Copenhagen University Hospital-Rigshospitalet, Glostrup DK-2600, Denmark.
Brain communications
|January 12, 2024
概括
停止治疗多发性硬化症的fingolimod可能会增加放射性疾病重新激活的风险,新的T2病变表明了这一点. 具有先前疾病活动的年轻女性面临更高的风险,需要立即开始治疗.
科学领域:
- 神经学 神经学
- 免疫学 免疫学 免疫学
- 放射学 放射学是一门学科.
背景情况:
- 芬戈利莫德是复发性复发性硬化症 (RRMS) 的常见疾病修饰疗法.
- 以前的报道表明,在停止使用fingolimod时,疾病复发的风险增加.
研究的目的:
- 为了调查在停止使用fingolimod.com后放射性疾病重新激活的风险.
- 为了确定患有更高风险的疾病复激活后fingolimod.患者子组.
主要方法:
- 在丹麦进行全国性队列研究 (2014年1月 - 2023年1月).
- 包括停止服用芬戈利莫德或二甲基烟酸的RRMS患者,以及停药前和后的MRI.
- 倾向性得分匹配被用于比较.
- 一个预测模型确定了新的T2病变的风险因素.
主要成果:
- 与二甲基烟酸相比,停止使用fingolimod与新T2病变的风险更高 (分别为1-2和≥3病变的OR值为1.8和4.4).
- 在停止使用芬戈利莫德的患者中,17%出现1-2个新的T2病变;17%出现≥3.3个病变.
- 预测模型确定了fingolimod治疗期间的疾病活动和40岁以下的女性性别作为风险因素.
结论:
- 停止使用fingolimod可以导致放射性疾病的重新激活,由新的T2病变证明.
- 临床警至关重要,特别是对于以前有疾病活动的年轻女性来说.
- 建议优先考虑及时启动替代疾病修饰疗法.
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