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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:

  • 伴随性疾病与更糟糕的多发性硬化症 (MS) 结果有关,但其对疾病活性的影响不太清楚.
  • 在MS的疾病活动包括复发,残疾恶化和磁共振成像 (MRI) 病变.

研究的目的:

  • 调查参与临床试验的MS患者的并发症和疾病活性之间的关联.
  • 评估伴随性疾病负担如何影响与临床实践和研究相关的多发性硬化症疾病活动指标.

主要方法:

  • 对17项MS疾病修饰疗法 (DMT) 3期临床试验的个人参与者数据进行了元分析.
  • 在2年的随访期间,分析了16794名患有多发性硬化症的参与者的数据.
  • 在试验招生时评估了并发症负担和特定条件;疾病活性 (EDA) 的证据是主要结果.

主要成果:

  • 较高的并发症负担与MS患者疾病活性 (EDA) 证据的危险性增加有关.
  • 具体来说,有三种或更多的并发症 (调整后危险比率[AHR],1.14) 或两种或更多的心脏代谢状况 (AHR,1.21) 显著增加EDA风险.
  • 一种精神疾病的存在也与EDA的更高风险有关 (AHR,1.07).

结论:

  • 增加的并发症负担与更大的MS疾病活动有关,包括复发和MRI病变.
  • 伴随性疾病可能起到MS中负面预后因素的调解作用.
  • 在MS患者的临床实践中,预防和治疗并发症至关重要.