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在多发性硬化症中首线使用更高效的疾病修饰疗法:加拿大共识建议
Mark S Freedman1, Fraser Clift2, Virginia Devonshire3
1University of Ottawa Department of Medicine, and the Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
概括
更高效的疾病修饰疗法 (HE-DMT) 对于控制多发性硬化症 (MS) 进展至关重要. 这一共识提供了专家指导方针,用于最佳的HE-DMT使用,以改善患者的治疗结果.
科学领域:
- 神经学 神经学
- 免疫学 免疫学 免疫学
- 神经免疫学 神经免疫学
背景情况:
- 多发性硬化症 (MS) 涉及中枢神经系统的炎症,导致神经轴损伤和残疾.
- 更高效的疾病修饰疗法 (HE-DMT) 越来越需要用于管理复杂的多发性硬化病理并改善长期结果.
研究的目的:
- 为在多发性硬化症的临床实践中最佳使用HE-DMTs建立共识建议.
- 为加拿大治疗多发性硬化症患者的临床医生提供实用指南.
主要方法:
- 一个由12名多发性硬化症专家组成的加拿大小组召开了会议.
- 用德尔菲方法制定了27个共识建议.
- 被考虑的HE-DMT包括单克隆抗体 (natalizumab,ocrelizumab,ofatumumab) 和免疫复合剂 (alemtuzumab,cladribine).
主要成果:
- 建议涵盖了对攻击性MS的定义,对HE-DMTs的患者选择,以及必要的基线调查.
- 这些指导方针涉及有效性监测,确定次优反应,以及血清神经丝-光链的作用.
- 该共识还包括关于安全监测,衰老/免疫效应以及治疗缓解或停止治疗的指导.
结论:
- 协商一致的建议旨在在MS管理中标准化HE-DMT的使用.
- 预计这些指导方针的实施将改善多发性硬化症患者的长期结果.
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