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复发性复发性多发性硬化症中复发独立和复发相关残疾进展的性别差异:现实世界的反向概率加权研究

Matteo Foschi^1,2, Damiano Marastoni³, Ivan Panzera⁴

¹Department of Neuroscience, Multiple Sclerosis Center-Neurology Unit, S. Maria delle Croci Hospital, AUSL Romagna, Viale Vincenzo Randi 5, Ravenna 48121, Italy.

Therapeutic advances in neurological disorders

|September 26, 2025

概括

患有多发性硬化症 (MS) 的女性面临的进展风险更高,独立于复发活动 (PIRA) 和磁共振成像 (MRI) 活动 (PIRMA),特别是绝经后的个人. 然而,男性在这些事件中经历了更大的残疾恶化,根据最初的症状和治疗而有所变化.

科学领域:

神经学神经学
神经免疫学神经免疫学
流行病学流行病学

背景情况:

多发性硬化症 (MS) 进展的性别差异尚未得到充分理解,特别是与复发无关的残疾恶化问题.
描述这些差异对于个性化MS管理和了解疾病轨迹至关重要.

研究的目的:

在现实世界MS队列中,评估性别特异性进展风险,独立于复发活动 (PIRA) 和磁共振成像 (MRI) 活动 (PIRMA).
量化PIRA,PIRMA和复发相关恶化 (RAW) 对残疾累积的贡献.
探索这些性别特异性影响在不同的临床子组中如何变化.

主要方法:

对患有复发性复发性多发性硬化症的成年人进行了反向概率加权分析.
针对复发事件的加权条件比例危险模型被用于比较性别特异性风险.
分析根据访问/MRI频率进行了调整,并检查了各子组之间的相互作用 (年龄,症状位置,病变负载,治疗).

主要成果:

妇女对PIRA和PIRMA的危险性显著更高,在绝经后的妇女中具有明显的影响.
与复发相关的恶化 (RAW) 风险在性别之间相似,尽管女性复发率更高.
男性在每次PIRA和PIRMA事件中经历了更大的扩展残疾状态量表 (EDSS) 恶化.
性相互作用对症状发作位置和初始疾病修饰疗法 (DMT) 选择具有意义.

结论:

妇女,特别是绝经后妇女,在MS中面临PIRA和PIRMA的风险增加.
在男性中,每次PIRA/PIRMA事件的残疾恶化更为显著.
性别对MS进展的影响因最初的临床表现和治疗策略而异.

关键词:

身体残疾就是残疾.多发性硬化症多发性硬化症进展独立于复发活动的进展.进展独立于复发和MRI活动.与复发相关的恶化.在性爱中,性爱是性爱.

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