纳塔利祖马布在二级渐进性多发性硬化症的长期有效性:一项倾向匹配研究
Clara G Chisari1, Umberto Aguglia2, Maria Pia Amato3
1Department "GF. Ingrassia"; Section of Neurosciences, University of Catania, Italy; UOS Sclerosi Multipla, AOU Policlinico "G. Rodolico-San Marco", University of Catania, Catania, Italy.
概括
与干扰素β-1b (IFNb-1b) 相比,对二次进展性多发性硬化症 (SPMS) 患者的纳塔利祖马布 (NTZ) 治疗显示出明显更好的残疾结果. 接受NTZ治疗的SPMS患者在48个月内经历了不太确定的残疾恶化和进展,独立于复发.
科学领域:
- 神经学 神经学
- 免疫学 免疫学 免疫学
- 临床试验 临床试验
背景情况:
- 二次渐进性多发性硬化症 (SPMS) 的治疗选择有限,最近的批准针对复发形式.
- 关于长期SPMS治疗疗效的现实数据对于临床决策至关重要.
研究的目的:
- 为了比较SPMS患者治疗纳塔利祖马布 (NTZ) 与干扰素β-1b (IFNb-1b) 的残疾进展情况.
- 评估NTZ和IFNb-1b在管理SPMS中的长期 (48个月) 有效性.
主要方法:
- 一项多中心的回顾性研究,涉及根据2014年卢布林标准诊断的SPMS患者.
- 倾向性得分匹配用于纠正NTZ和IFNb-1b治疗组之间的非随机化.
- 评估的结果包括已确认的扩大残疾状况尺度恶化 (CEW) 和不依赖复发的进展 (PIRA).
主要成果:
- 在匹配后,102名患者接受了NTZ,98人接受了IFNb-1b.
- 与IFNb-1b组相比,NTZ组中观察到48个月CEW (30.4%对58.2%) 和PIRA (40.2%对72.4%) 的比率明显较低 (p <0.01对两者).
- 较高的基线EDSS和较长的SPMS持续时间是PIRA的风险因素;IFNb-1b治疗增加了PIRA的可能性 (HR 1.64).
结论:
- 与干扰素β-1b相比,SPMS患者的纳塔利祖马布治疗在48个月内显示出更有利的残疾结果.
- 在SPMS中,NTZ可能有助于减缓残疾进展,特别是不依赖复发的进展.
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