在复发性多发性硬化症治疗缓解/停止后,疾病复发的风险分层根据VIAADISC得分
Gabriel Bsteh1, Vincenzo Introcaso2, Christiane Gradl3
1Department of Neurology, Medical University of Vienna, Austria; Comprehensive Center for Clinical Neurosciences & Mental Health, Medical University of Vienna, Austria.
Multiple sclerosis and related disorders
|August 22, 2025
概括
在停止疾病修饰治疗 (DMT) 后,VIAADISC评分预测了复发性多发性硬化症 (RMS) 患者的疾病复发. 较低的分数表明风险较低,特别是对于二甲基和特里弗卢诺米德,而较高的分数则表明 natalizumab 和 fingolimod 的风险较高.
科学领域:
- 神经学
- 免疫学
- 临床试验
背景情况:
- 复发性多发性硬化症 (RMS) 的治疗包括疾病修饰疗法 (DMT).
- 在RMS中降级或停止DMT需要仔细评估疾病复发的风险.
- 需要预测工具来指导DMT降级/停止决策.
研究的目的:
- 评估VIAADISC评分在降低或停止DMT后预测RMS患者疾病复发的能力.
- 根据患者特征和之前的DMT来分层重新激活风险.
主要方法:
- 对129名RMS患者进行了回顾性分析,这些患者的DMT治疗程度降低或停止.
- 根据年龄,MRI活动和临床稳定的持续时间计算VIAADISC得分.
- 随访时间平均为6.0年,以评估疾病的复发 (复发和/或残疾进展).
主要成果:
- 在停用纳塔利祖马布 (NTZ) 或芬戈利莫德 (FTY) 后,病例复发率在55. 0%的患者中出现.
- 较高的VIAADISC分数独立预测疾病的重新激活 (HR为1.25分).
- 在停止使用VIAADISC< 2时,没有观察到二甲基酸盐 (DMF) 或特里弗隆胺 (TERI) 的重新激活.
结论:
- VIAADISC评分可以对DMF/ TERI停药的再激活风险进行分层,这表明长期稳定的老年患者的安全性.
- 从NTZ/FTY降级带来重新激活的高风险,使横向切换成为首选的策略.
- 在RMS中进行个性化风险评估的VIAADISC评分.
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