延迟接入和坚持是现实世界中的挑战,这些挑战会影响纳塔利祖马布在多发性硬化症中的有效性
Rafael Augusto Rosalem1, Mariana Gondim Peixoto Spricigo1, Mateus Boaventura de Oliveira1
1Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR.
Multiple sclerosis and related disorders
|August 1, 2025
概括
及时获得和坚持纳塔利祖马布治疗对于治疗多发性硬化症至关重要. 在MS患者中,延迟治疗和不坚持治疗增加了残疾和复发风险.
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:
- 高效疗法对于预防多发性硬化症 (MS) 的残疾至关重要.
- 纳塔利祖马布是MS的关键治疗方法,但它的有效性取决于时间和坚持.
- 这项研究调查了巴西多发性硬化症患者延迟获得和不坚持纳塔利祖马布的情况.
研究的目的:
- 评估延迟纳塔利祖马布开始对MS患者残疾进展的影响.
- 评估不坚持纳塔利祖马布治疗对MS患者复发率的影响.
- 为了确定停止纳塔利祖马布治疗的原因.
主要方法:
- 在巴西圣保罗,对88名多发性硬化患者进行了回顾性,单中心的观察性研究.
- 数据包括人口统计,疾病过程,治疗史,复发,临床/放射学活动,坚持和残疾 (扩展残疾状况量表 - EDSS).
- 患者被分为早期 (症状发作后<48个月) 和晚期 (≥48个月) 的纳塔利祖马布治疗组.
主要成果:
- 大多数患者 (78%) 迟迟开始服用纳塔利祖马布.
- 晚期治疗与EDSS≥6的更高频率有关 (32%对11%,p=0.024).
- 四分之一的患者不坚持,面临三倍高的复发风险 (55%对17%,p<0.001). 停用纳塔利祖马布主要是由于感知到渐进的多焦点白血脑病的风险 (72%),没有报告的病例.
结论:
- 早期获得natalizumab对于MS的最佳结果至关重要.
- 改善患者对纳塔利祖马布的坚持是最大化治疗效益的关键.
- 解决及时和一致使用纳塔利祖马布的障碍可以减少MS中的残疾和复发.
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