二次进展性多发性硬化症的当前挑战:诊断,活动检测和治疗
Luis Brieva1,2,3, Carmen Calles4, Lamberto Landete5
1Neurology Department, Hospital Universitari Arnau de Vilanova, Lleida, Spain.
Frontiers in immunology
|April 7, 2025
概括
早期诊断二级渐进性多发性硬化症 (SPMS) 是具有挑战性的,影响治疗开始. 本综述探讨了用于有效管理SPMS的诊断障碍和生物标志物的使用.
科学领域:
- 神经学 神经学
- 神经免疫学 神经免疫学
- 临床医学 临床医学
背景情况:
- 复发性复发性多发性硬化症 (RRMS) 往往会发展为二级渐进性多发性硬化症 (SPMS).
- 早期的SPMS诊断和有效的治疗带来了重大的临床挑战.
- 有限的疾病修饰疗法 (DMT) 存在于渐进性多发性硬化症,通常需要证明疾病活性.
研究的目的:
- 审查早期SPMS诊断中的挑战.
- 总结目前和潜在的生物标志物用于SPMS进展的应用.
- 讨论DMT启动困难以及活跃和非活跃的SPMS的治疗选择.
主要方法:
- 对SPMS的诊断标准的文献综述.
- 对疾病进展的生物标志物研究的分析.
- 检查DMT批准和临床试验数据的SPMS.
主要成果:
- 由于缺乏确定的诊断标准,SPMS的识别延迟了.
- 生物标志物显示出跟踪SPMS进展的潜力.
- 对于活跃的SPMS来说,启动DMT可能很困难,特别是当现有的治疗方法掩盖炎症活动时.
结论:
- 早期的SPMS诊断需要改进的标准和验证的生物标志物.
- 优化DMT用于活跃的SPMS使用需要对疾病活动进行仔细监测.
- 治疗策略必须考虑活跃和非活跃的SPMS,包括适当停止治疗.
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