多发性硬化症从发病到次要进展:一项为期30年的意大利注册研究
Aurora Zanghì1, Massimiliano Copetti2, Carlo Avolio1
1Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.
Journal of neurology, neurosurgery, and psychiatry
|June 15, 2025
概括
疾病修饰疗法 (DMT) 改善了多发性硬化症 (MS) 管理. 30多年来,DMT的使用降低了MS患者的二次进展 (SP) 风险,这表明疾病控制更好.
科学领域:
- 神经学 神经学
- 临床流行病学临床流行病学
背景情况:
- 疾病修饰疗法 (DMT) 已经存在了三十年.
- 在治疗复发性多发性硬化症 (MS) 方面取得了重大进展,但在控制疾病进展方面仍然存在挑战.
研究的目的:
- 分析多发性硬化症在30年的长期发展过程.
- 通过不同治疗时期,研究从复发性缓解性多发性硬化到次级渐进性多发性硬化 (SP) 的过渡.
主要方法:
- 一个队列研究,利用从意大利MS登记处前性收集的数据.
- 对9958名患者的分析,在30年的随访期内使用数据驱动算法定义二次进展 (SP).
- 五个不同的疾病发病时期的SP转化率的比较.
主要成果:
- 1364名患者 (13.7%) 在平均8.5年后转换为SP.
- 从来没有接受过DMT的患者与接受治疗的患者相比,SP转化率更高 (9.9%) (5.2%).
- 随着时间的推移,SP发病率下降,从第一个时代的1.98下降到第五个时代的1.15. 治疗覆盖率的增加与SP的风险降低有关.
结论:
- 在过去的30年里,SP转换率在MS中一直在下降.
- 改善DMT治疗覆盖率是减少SP的一个关键因素.
- 未来的研究应该专注于了解和管理MS进展的综合模型.
关键词:
多发性硬化 多发性硬化相关概念视频
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