抗雄激素修饰疗法对患有多发性硬化症的老年男性疾病活性的影响
Burcu Zeydan1, Nur Neyal2, Nabeela Nathoo3
1Department of Neurology, Mayo Clinic, Rochester, MN, USA; Department of Radiology, Mayo Clinic, Rochester, MN, USA; Women's Health Research Center, Mayo Clinic, Rochester, MN, USA; Center for Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic, Rochester, MN, USA.
在患有多发性硬化症 (MS) 的老年男性中,雄激素修饰疗法 (AMT) 并没有减少,而是持续或增加了疾病活性. 密切监测这些患者至关重要.
科学领域:
- 神经学 神经学
- 内分泌学 在内分泌学.
- 免疫学 免疫学 免疫学
背景情况:
- 雄激素具有抗炎性质,对其在多发性硬化症 (MS) 的作用的临床数据有限.
- 多发性硬化症的炎症活性通常随着年龄的增长而降低,而模仿降低雄激素水平的雄激素修饰疗法 (AMT) 在老年男性中很常见.
- 这项研究调查了AMT对老年男性多发性硬化症 (MPwMS) 患者疾病活性的影响.
研究的目的:
- 为了确定雄激素修饰疗法 (AMT) 是否会增加55岁及以上多发性硬化症 (MPwMS) 的老年男性患者的疾病活性.
- 为了比较老年MPwMS中AMT启动前后的临床,放射学和整体疾病活动事件.
- 评估AMT对这一人口群体中MS进展的长期影响.
主要方法:
- 一个观察性研究队列包括MPwMS在55岁以上开始AMT (AMT组,n=60) 和没有AMT史的人 (没有AMT组,n=80).
- 评估了临床 (复发),放射性 (新病变) 和疾病 (复发和/或新病变) 活动事件.
- 在两组中,AMT启动年龄之前和之后的数据进行了比较.
主要成果:
- 虽然没有AMT组在开始后的临床,放射和疾病活动事件的年龄下降,但AMT组的临床活动下降不那么明显.
- 与基线相比,AMT组的放射性活动事件和持续的疾病活动增加.
- 虽然3年后AMT组的疾病活性较高,但这种差异在统计学上并不显著 (p=0.582).
结论:
- 与预期相反,接受雄激素修饰疗法 (AMT) 的男性多发性硬化症患者 (MPwMS) 显示出持续或增加的疾病活性,特别是在65岁之后.
- 这表明AMT可能不会给老年男性带来预期的与年龄相关的MS活动减弱.
- 建议加强对MPwMS启动AMT的临床监测.
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