脊柱肌肉缩的组合疗法:一个系统的审查
Maryam Bemanalizadeh1,2, Leida Heidary3, Mohammad Sedigh Dakkali4
1Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
在脊柱肌肉缩 (SMA) 治疗中,使用nusinersen,onasemnogene abeparvovec-xioi和risdiplam的组合疗法具有前景. 虽然在短期内通常是安全的,但长期的疗效和最佳测序需要进一步研究.
科学领域:
- 神经学
- 遗传学
- 药理学
背景情况:
- 脊柱肌肉缩 (SMA) 有三种疾病修饰疗法.
- 在所有SMA患者中,单一治疗可能无法阻止疾病的进展.
- 对于SMA,正在出现组合疗法 (补充/切换).
研究的目的:
- 评估SMA组合疗法的安全性,疗效和临床应用.
- 评估组合治疗与单一治疗的潜在优势.
- 分析使用nusinersen,onasemnogene abeparvovec-xioi和risdiplam的双重和三重组合疗法.
主要方法:
- 从主要数据库 (PubMed,Scopus,Web of Science,ClinicalTrials.gov) 进行到2025年5月的研究的系统审查.
- 包括双重或三重组合疗法 (交换或补充) 的研究.
- 提取人口统计,治疗方案,运动功能和不良事件的数据;评估研究质量.
主要成果:
- 19项研究和6项正在进行的试验符合纳入标准,分析了29名患者.
- 转换疗法是常见的,通常从nusinersen或risdiplam转换为onasemnogene abeparvovec-xioi.
- 组合治疗方案一般耐受良好;一些患者在早期干预后表现出改善的运动里程碑和呼吸功能.
结论:
- 对SMA的组合疗法是可行的,并且通常是安全的,特别是对单一治疗反应不佳的患者.
- 目前的证据令人鼓舞,
- 强大的长期试验对于确定真正的疗效,最佳测序和更广泛的影响至关重要.
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