对多发性硬化症疲劳的药理疗法的有效性:系统性审查和元分析
Karlo Toljan1, Albert Aboseif2, Moein Amin1
1Mellen Center for Multiple Sclerosis Treatment and Research, Cleveland Clinic, Cleveland, OH, USA.
Multiple sclerosis and related disorders
|March 5, 2025
概括
药物治疗对减少多发性硬化症患者 (PwMS) 疲劳的有效性很小. 这些药物还增加了因副作用而导致停药的风险,提供了不确定的临床益处.
科学领域:
- 神经学 神经学
- 临床药理学 临床药理学
背景情况:
- 疲劳是患有多发性硬化症 (PwMS) 的人中普遍存在和使人衰弱的症状.
- 它显著影响生活质量,增加医疗保健成本.
- 现有的对MS疲劳的药理疗法产生了相互矛盾的结果.
研究的目的:
- 系统地审查随机临床试验 (RCT),评估阿曼塔丁,莫达菲尼尔,甲基酸盐和4-阿米诺皮里丁对MS疲劳的疗效和耐受性.
- 将这些干预措施与安慰剂或其他治疗方法进行比较.
主要方法:
- 在PubMed和CENTRAL系统搜索相关的RCT.
- 包括对经历疲劳的成年PwMS的研究.
- 评估的结果包括疲劳严重程度 (FSS,MFIS,VAS) 和因不良事件而中止治疗的比例.
主要成果:
- 十六项研究符合纳入标准.
- 药物对疲劳严重性的影响很小,但在统计学上不显著 (SMD -0.26).
- 随着药物的使用,由于副作用而导致停药的风险显著增加 (RR 2.11).
结论:
- 审查的药物在减少PwMS疲劳方面具有很小或没有显著的有效性.
- 由于有效性有限,副作用负担增加,临床意义尚不确定.
- 可能需要进一步的研究来确定MS中有效的疲劳管理策略.
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