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进展性多发性硬化症的疾病修饰疗法:随机对照试验的系统审查和网络元分析

Xin Wu¹, Shixin Wang¹, Tao Xue²

¹Department of Neurosurgery and Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.

Frontiers in neurology

|March 26, 2024

概括

疾病修饰疗法 (DMT) 通过延缓疾病进展,有效地管理渐进性多发性硬化症 (PMS). 米托克桑,西波尼莫德和奥克雷利祖马布在减缓残疾进展方面表现出卓越的疗效.

科学领域:

神经学神经学
临床药理学临床药理学
基于证据的医学基于证据的医学.

背景情况:

疾病修饰疗法 (DMT) 对于管理渐进性多发性硬化症 (PMS) 至关重要.
现有DMT治疗PMS的比较疗效和安全性仍然不完全理解.
确定最佳的DMT对于改善患者预后和缓解症状至关重要.

研究的目的:

系统地审查和评估DMT治疗PMS的疗效和安全性.
确定最有效的DMT来改善PMS患者的治疗结果.
为了比较不同的DMT在延缓疾病进展和减轻残疾方面的表现.

主要方法:

在MEDLINE,EMBASE,Cochrane图书馆和clinicaltrials.gov的系统文献搜索到2023年1月30日.
包括18项随机对照试验 (RCT),涉及9234名患者.
使用网络元分析 (CINeMA) 框架的信心评估证据确定性,并估计风险比率和平均差异.

主要成果:

德米抗药有效控制多发性硬化症的进展;米托克桑,西波尼莫德和奥克雷利祖马布在延缓进展方面优越 (高度确定性).
米托克桑在减轻残疾进展方面表现出最好的疗效 (高确定性).
特定药物在功能测试 (Ocrelizumab用于T25FW,Natalizumab用于9HPT) 和成像结果 (IFN-beta-1b用于T2病变,Siponimod用于T2病变体积) 中显示出优势. 利图西马布和拉基尼莫德在AEs中显示出有效性,而纳塔利祖马布和奥克雷祖马布在SAEs方面更安全.

结论:

德米特在控制疾病进展和减少PMS恶化方面是有效的.
特定的DMT如米托克桑,西波尼莫德和奥克雷利祖马布在延缓进展和残疾方面提供了卓越的好处.
这些发现为在临床实践中为PMS管理选择最佳的DMT提供了宝贵的见解.

关键词:

改变疾病的疗法.多发性硬化症多发性硬化症在那个时候,她生下了Natalizumab.这就是Ocrelizumab.随机对照的随机控制的这就是Rituximab.

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