早期强化与升级方法:在复发性多发性硬化症中对残疾的十年影响
Pietro Iaffaldano1, Giuseppe Lucisano2, Tommaso Guerra1
1Department of Translational Biomedicines and Neurosciences (DiBraiN), University of Bari "Aldo Moro", Bari, Italy.
Annals of clinical and translational neurology
|July 7, 2025
概括
与高效疾病修饰疗法 (HE-DMT) 进行的早期密集治疗 (EIT) 与升级策略相比,在复发性多发性硬化症 (RMS) 中显著减缓残疾进展. 这种方法优化了RMS患者的长期结果.
科学领域:
- 神经学 神经学
- 免疫学 免疫学 免疫学
- 临床研究 临床研究
背景情况:
- 复发性多发性硬化症 (RMS) 具有不可预测的神经障碍的特征.
- 治疗策略旨在缓解疾病进展并保持患者的功能.
- 高效疾病修饰疗法 (HE-DMT) 代表了先进的治疗选择.
研究的目的:
- 将早期密集治疗 (EIT) 与使用HE-DMT的升级 (ESC) 策略对RMS残疾进展的长期影响进行比较.
- 评估治疗时间对残疾轨迹和特定恶化的事件的影响.
主要方法:
- 来自意大利多发性硬化病登记册的4878名RMS患者的观察研究,随访时间≥5年.
- 患者被分类为EIT (即时HE-DMTs) 或ESC (在中度疗效治疗≥1年后的HE-DMTs).
- 倾向性得分匹配用于平衡基线特征;使用线性混合模型和Cox比例危险模型分析结果.
主要成果:
- 与ESC组相比,EIT组在10年内显示残疾进展明显较慢 (delta-EDSS差异-0.63).
- ESC与确认残疾累积 (CDA),不依赖复发活动的进展 (PIRA) 和复发相关恶化 (RAW) 的风险增加有关.
结论:
- 使用HE-DMT的早期密集治疗 (EIT) 显著减少了RMS的长期残疾进展.
- 早期启动HE-DMT可能会优化长期结果,并降低RMS患者各种残疾恶化事件的风险.
相关概念视频
01:19Autism Spectrum Disorder
344
Autism spectrum disorder (ASD) is a neurodevelopmental condition marked by persistent deficits in social communication and interaction alongside restrictive and repetitive behaviors or interests. ASD is sometimes accompanied by intellectual impairment.
These core symptoms manifest differently among individuals, ranging from mild to severe. The disorder's complexity extends beyond its clinical presentation, encompassing a diverse range of biological, cognitive, and sociocultural influences.
These core symptoms manifest differently among individuals, ranging from mild to severe. The disorder's complexity extends beyond its clinical presentation, encompassing a diverse range of biological, cognitive, and sociocultural influences.
344
01:29Psychological and Sociocultural Causes of Schizophrenia
192
Schizophrenia, a complex psychiatric disorder, has been historically misunderstood. Early psychological theories attributed its origins to childhood trauma and unresponsive parenting. However, contemporary research largely rejects these notions, favoring the vulnerability-stress hypothesis. This model proposes that individuals with a genetic predisposition to schizophrenia may develop the disorder following exposure to significant environmental stressors. Notably, studies on high-risk...
192
01:17Classification of Illness
8.0K
The meaning of illness is individualized to each person who experiences an alteration in health. In contrast, disease is a medical term indicating a pathological change in the structure and function of the body or mind. It is a condition that has specific symptoms and boundaries.
An illness is a response to a disease in which the person's level of functioning is changed compared with a previous level. The general classification of illness includes acute and chronic.
Acute illness is severe...
An illness is a response to a disease in which the person's level of functioning is changed compared with a previous level. The general classification of illness includes acute and chronic.
Acute illness is severe...
8.0K