口腔疾病修饰剂及其粘附轨迹与多发性硬化症每年复发的关联
Jagadeswara Rao Earla1, Jieni Li1, George J Hutton2
1Department of Pharmaceutical Health Outcomes and Policy, College of Pharmacy, University of Houston, TX, USA.
Multiple sclerosis and related disorders
|April 4, 2024
概括
对口服疾病修饰剂 (DMAs) 的长度坚持显著影响了多发性硬化症 (MS) 的复发率. 附着性迅速下降的患者比完全附着的患者有更多的复发.
科学领域:
- 神经学 神经学
- 药理学 药理学是指药理学的学科.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 在多发性硬化症 (MS) 中,口腔疾病修饰剂 (DMA) 的实际有效性可能因附着性模式而异.
- 以前的研究还没有充分探索纵向粘附轨迹对MS患者口服DMA的影响.
研究的目的:
- 评估口服DMA,它们的坚持轨迹和成年多发性硬化症患者的年度复发率 (ARR) 之间的关联.
- 为了识别常见的口服DMAs,随着时间的推移,药物坚持的不同模式.
主要方法:
- 使用2015-2019年MarketScan数据库对994名成年多发性硬化症患者的回顾性分析.
- 基于组的轨迹建模 (GBTM) 根据覆盖日数比例 (PDC) 确定了依从模式 (完整,缓慢下降,快速下降).
- 基于模型的治疗重量的反向概率与负二项式回归分析了ARR.
主要成果:
- 确定了三个坚持轨迹:完全坚持 (59.2%),缓慢下降 (23.8%) 和快速下降 (17.0%).
- 与完全坚持者相比,快速下降的人显示出明显更高的ARR (aIRR:1.6).
- 在fingolimod, teriflunomide和dymethyl fumarate之间没有观察到ARR的显著差异,而DMA类型并没有缓解坚持-复发关系.
结论:
- 快速下降的口服DMA的坚持与MS患者复发率的增加有关.
- 长途药物坚持是管理和减少多发性硬化症复发的关键因素.
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