在奥地利的复发性多发性硬化症患者中使用纳塔利祖马布缓解升级治疗策略
Michael Guger1,2, Christian Enzinger3, Bettina Heschl3
1Department of Neurology, Pyhrn-Eisenwurzen Hospital Steyr, Steyr, Austria.
European journal of neurology
|July 5, 2025
概括
从纳塔利祖马布 (NTZ) 降级到其他疗法增加了复发风险和EDSS分数的恶化. 过渡性ARR和EDSS等因素影响复发概率和进展.
科学领域:
- 神经学 神经学
- 免疫学 免疫学 免疫学
- 药理学 药理学是指药理学的学科.
背景情况:
- 纳塔利祖马布 (NTZ) 是治疗多发性硬化症 (MS) 的一种高效疗法.
- 降级到中度有效的疗法是一个常见的策略,但它的有效性需要评估.
- 了解缓和局势的结果对于优化多发性硬化症管理至关重要.
研究的目的:
- 评估从纳塔利祖马布 (NTZ) 降级到各种适度有效的多发性硬化症疗法的疗效.
- 为了比较从NTZ切换后的复发率和扩展残疾状态量表 (EDSS) 变化.
- 为了确定与复发风险和残疾进展后降级相关的因素.
主要方法:
- 分析了奥地利多发性硬化治疗登记处的388名从NTZ转换为克拉迪宾,二甲基 fumarate,fingolimod,ponesimod,siponimod或teriflunomide的患者的数据.
- 患者必须接受NTZ至少3个月,并接受缓解升级治疗至少3个月.
- 评估每年复发率 (ARR) 和EDSS分数,平均治疗时间为42个月.
主要成果:
- 与高效疗法 (0.22) (p=0.009) 相比,降级疗法显示出更高的估计ARR (0.36).
- 在降级期间,EDSS得分从2.8显著增加到3.1 (p<0.001).
- 治疗间隔期间复发的概率随着时间间隔的延长而增加,男性性别,较低的基线ARR,年龄较大,疾病持续时间较短和EDSS较低等因素与复发风险降低有关.
结论:
- 从纳塔利祖马布减缓与复发和EDSS恶化的风险增加有关.
- 复发和EDSS进展的概率受到过渡期间的年度复发率和过渡期结束时的EDSS得分的影响.
- 在考虑从高效的多发性硬化症疗法减缓时,仔细选择和监测患者至关重要.
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