长期接受免疫调节治疗的多发性硬化症患者的真实感染风险
Clare McGarvey Lambert1, Taimoor Hussain2, John Peters1
1Department of Neurology, Yale New Haven Hospital, United States of America.
Multiple sclerosis and related disorders
|January 4, 2025
概括
多发性硬化症 (MS) 的疾病修饰性治疗可以增加感染风险. 纳塔利祖马布在长期多发性硬化症治疗中似乎是安全的,而吸烟剂在现实使用中与更严重的感染有关.
科学领域:
- 神经学 神经学
- 免疫学 免疫学 免疫学
- 药理学 药理学是指药理学的学科.
背景情况:
- 多发性硬化症 (MS) 治疗包括免疫调节药物,这些药物消耗,转移或调节免疫细胞.
- 对MS的疾病修饰治疗 (DMT) 增加了感染风险,可能随着长期使用而升级.
研究的目的:
- 评估成年多发性硬化症患者中与不同DMT相关的感染的真实发病率和严重程度.
- 评估治疗持续时间和患者特征对各种多发性硬化疗法感染风险的影响.
主要方法:
- 对成年多发性硬化患者进行了回顾性,单中心的观察队列研究,这些患者在两年多时间内接受了纳塔利祖马布,S1P调节剂,烟酸或抗CD20药物治疗.
- 分析医疗记录以识别和分类感染 (轻度和重度) 和统计建模 (零膨胀负双项回归) 以评估DMT的影响,控制患者因素.
主要成果:
- 在DMT之间,轻度感染率没有显著差异;然而,烟酸与较高的严重感染率有关.
- 较长的DMT持续时间和需要行走辅助器的需要与轻度感染率的增加相关.
- 渐进性多发性硬化和长期使用烟酸盐与更高的严重感染率有关,即使经过对共变量进行调整.
结论:
- 在MS中使用DMT的现实世界显示了受药物选择,治疗持续时间和患者特定因素影响的感染模式,与临床试验数据有所不同.
- 在长时间使用期间,纳塔利祖马布在感染方面表现出良好的安全性.
- 酸盐可能与严重感染的增加有关,这可能反映了患者选择基线健康状况较差的人;DMT持续时间可能预测轻度感染风险.
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