芬戈利莫德对复发性复发性多发性硬化症患者的焦点和扩散损伤的影响 - "进化"研究
Massimo Filippi1,2,3,4,5, Elisabetta Pagani6, Renato Turrini7
1Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy. filippi.massimo@hsr.it.
Journal of neurology
|July 29, 2024
概括
在复发性复发性多发性硬化症 (RRMS) 患者的芬戈利莫德治疗显示出神经保护作用,减少炎症活动并减缓大脑缩. 该研究表明,fingolimod限制了不可逆转的损害,提供了除其抗炎作用之外的潜在益处.
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:
- 多发性硬化症 (MS) 管理寻求缓解炎症和神经退行过程的治疗方法.
- 芬戈利莫德以其在MS中具有的抗炎作用而闻名,但其潜在的神经保护作用需要进一步研究.
- 评估fingolimod对不可逆转的大脑损伤的实际有效性对于优化患者的治疗结果至关重要.
研究的目的:
- 评估fingolimod在复发性复发性多发性硬化症 (RRMS) 患者中的神经保护作用.
- 确定fingolimod是否不仅可以减少炎症活动,还可以减少不可逆转的焦点和全脑损伤.
- 在现实世界中评估fingolimod对病变进展和脑缩的影响.
主要方法:
- 进化研究是一项为期24个月的前性,观察性,单臂,多中心试验,涉及261名RRMS患者开始fingolimod.
- 患者每两年接受神经学评估和每年进行MRI评估.
- 关键结果包括没有新的/扩大的T2高强度白质病变或复发,修改的"没有疾病活动4的证据" (NEDA-4),以及活跃病变的有限演变为永久黑洞 (PBH).
主要成果:
- 在24个月后,47.5%的患者没有显示出临床或MRI炎症活动.
- 22.9%的患者获得了修改后的NEDA-4状态,表明可以控制炎症和残疾进展.
- 61.1%的患者有不到40%的活跃病变演变为永久黑洞,这表明减少了不可逆转的损伤.
结论:
- 进化研究表明,fingolimod在RRMS患者中表现出神经保护性质.
- 芬戈利莫德似乎限制了炎症活动,大脑缩和永久黑洞的发展.
- 这些发现表明fingolimod可能在保护大脑结构方面提供好处,超出其免疫调节作用.
相关概念视频
01:29Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
755
Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
755
01:24Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF
880
Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab...
880
01:21Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids
692
Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
692
01:19Multiple Sclerosis l: Introduction
20
Multiple sclerosis is a chronic autoimmune disease of the central nervous system (CNS) that affects the brain, spinal cord, and optic nerves. It is an inflammatory demyelinating disorder and a leading cause of neurological disability in young adults.EpidemiologyMS commonly begins between 20 and 40 years of age and is twice as common in women. Its exact cause remains unclear, but genetic susceptibility contributes, with higher risk in first-degree relatives and identical twins. A greater...
20