在多发性硬化症治疗中使用ofatumumab,残疾累积
Masahiro Mimori1, Atsuko Katsumoto2, Tomoko Okamoto2
1Department of Neurology, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan; Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan.
Journal of the neurological sciences
|December 21, 2024
概括
在患有多发性硬化症 (MS) 的严重残疾患者 (EDSS分数高) 中,ofatumumab的效果可能较低. 在EDSS得分较低的多发性硬化患者中,早期开始治疗可能会导致更好的结果.
科学领域:
- 神经学 神经学
- 免疫学 免疫学 免疫学
背景情况:
- 奥法图穆马布在减少复发率和多发性硬化症 (MS) 中的残疾进展方面已经证明有效.
- 然而,它在严重残疾患者中的有效性,以高扩展残疾状态量表 (EDSS) 评分为准,需要进一步调查.
研究的目的:
- 为了评估ofatumumab治疗在MS患者高EDSS得分和延长疾病持续时间的结果.
- 为了确定与这种患者群体中ofatumumab反应相关的因素.
主要方法:
- 在日本对多发性硬化症患者接受了ofatumumab治疗的回顾性队列研究.
- 根据连续性,复发与EDSS恶化,以及在12个月后不依赖复发活动的进展 (PIRA),患者被分类为治疗反应或治疗耐药.
- 使用后勤回归分析来确定ofatumumab反应的预测因素.
主要成果:
- 分析了70名患者 (39例复发性复发,31例二次进展性多发性硬化症) 的EDSS中位数为4.5.
- 超过一半 (56%) 的患者被归类为耐治疗,二次进展性多发性硬化 (81%) 与复发性复发性多发性硬化 (33%) 相比,耐药性率更高.
- 较高的EDSS分数和实现无疾病活动证据 (NEDA-3) 是与ofatumumab反应相关的独立因素.
结论:
- 在具有更高EDSS分数的MS患者中,ofatumumab治疗结果可能不那么有利.
- 在EDSS得分较低的患者中,较早开始使用atumumab可能会带来更有益的效果.
更多相关视频
相关概念视频
Autoimmune Disorders
2.4K
Autoimmune diseases are a group of disorders in which the body's immune system mistakenly attacks its own cells, tissues, and organs. This results from an overactive immune response against substances and tissues normally present in the body. Let's delve into the concept and mechanism of autoimmune diseases from an immune system point of view, explore different causes and examples of such diseases, and discuss potential solutions.
Concept and Mechanism of Autoimmune Diseases
The immune...
Concept and Mechanism of Autoimmune Diseases
The immune...
2.4K
Drugs 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
Drugs 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
Drug Accumulation During Multiple Dosing: Repetitive IV Injections
527
Calculating drug dosage and accumulation in multiple-dose regimens is crucial for achieving therapeutic efficacy while avoiding toxicity. This involves determining the plasma drug concentrations over time to optimize dosing schedules. The principle of superposition is fundamental in this process, allowing for the prediction of drug concentration in plasma following multiple doses based on single-dose data.The principle of superposition asserts that the plasma concentration-time curves from...
527
Drug Accumulation During Multiple Dosing: Intermittent IV Infusions
423
Intermittent intravenous (IV) infusion is a method of drug administration where medications are delivered over short infusion periods followed by intervals of no drug delivery. This approach helps to prevent sustained high drug concentrations in the bloodstream, reducing the risk of adverse effects associated with prolonged exposure. Unlike continuous infusion, steady-state concentrations may not be achieved during a single dosing cycle but can be reached through repeated...
423
Multiple 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


