活跃和非活跃的继发性渐进性多发性硬化症患者表现出类似的残疾进展:意大利多发性硬化症注册研究 (ASPERA) 的结果
Clara Grazia Chisari1,2, Maria Pia Amato3, Alessia Di Sapio4
1Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", Multiple Sclerosis Center, University of Catania, Catania, Italy.
Journal of neurology
|August 27, 2024
概括
大多数二次进展性多发性硬化症 (SPMS) 患者是非活跃的,进展主要是由不依赖复发的因素驱动的. 这表明PIRA是SPMS中残疾的主要驱动因素,而不是活跃疾病.
科学领域:
- 神经学 神经学
- 免疫学 免疫学 免疫学
- 临床研究 临床研究
背景情况:
- 二次渐进性多发性硬化症 (SPMS) 的特点是有不同的活性和非活性形式.
- 关于活跃与非活跃SPMS的频率和特征的现实数据有限.
- 了解这些差异对于疾病管理和治疗策略至关重要.
研究的目的:
- 为了确定在一个大意大利队列中活跃和非活跃的SPMS的频率.
- 为了比较活跃和非活跃的SPMS之间的临床和MRI特征.
- 分析疾病进展模式,包括不依赖复发活动的进展 (PIRA) 和复发相关恶化 (RAW).
主要方法:
- 在2014年至2019年期间,意大利多发性硬化患者过渡到SPMS的多中心研究.
- 根据MRI和前一年的复发数据,将SPMS分类为"活跃"或"非活跃".
- 对临床数据,MRI特征和残疾进展 (EDSS分数,PIRA,RAW) 的分析.
主要成果:
- 在8,316名SPMS患者中,有10.5% (872) 被分类为:27.2%的活跃SPMS和72.8%的非活跃SPMS.
- 非活跃的SPMS患者年龄较大,疾病持续时间较长.
- 在两组中,PIRA的发病率相似 (27.4%的活跃患者和29.6%的非活跃患者). 在活跃的SPMS患者中,RAW发生在15.2%的患者中.
- 活跃和非活跃的SPMS组之间没有显著的EDSS 6或7生存差异.
结论:
- 在这个队列中,大多数SPMS患者被归类为非活跃.
- 在SPMS中,疾病的进展似乎主要是由PIRA驱动的,无论疾病的活跃状态如何.
- 疾病活动对SPMS中整体残疾进展的贡献很小.
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