在接受纳塔利祖马布治疗的多发性硬化症患者中,长期渐进的多焦点白细胞脑病的风险分层,具有阳性约翰·坎宁汉姆病毒指数
Natalia Szejko1,2,3,4, Aleksandra Podlecka-Pietowska5, Monika Nojszewska5
1Department of Bioethics, Medical University of Warsaw, Warsaw, Warsaw, Poland. natalia.szejko@gmail.com.
Neurologia i neurochirurgia polska
|November 25, 2025
概括
长期纳塔利祖马布治疗对于多发性硬化症 (MS) 患者,具有阳性约翰坎宁汉病毒 (JCV) 指数,是安全的. 像延长剂量间隔和频繁的MRI监测等预防措施是安全的,长期MS管理的关键.
科学领域:
- 神经学 神经学
- 免疫学 免疫学 免疫学
- 病毒学 病毒学
背景情况:
- 接受纳塔利祖马布治疗的多发性硬化症 (MS) 患者,如果对约翰·坎宁汉病毒 (JCV) 呈阳性,则存在进展性多焦点白血脑病 (PML) 的风险.
- 虽然已知短期结果,但纳塔利祖马布在JCV阳性MS患者的长期安全性和疗效数据仍然有限.
研究的目的:
- 评估纳塔利祖马布治疗在多发性硬化症患者的长期随访和安全性,这些患者的John Cunningham病毒 (JCV) 指数为阳性.
- 根据不同的JCV指数水平和实施风险减轻策略来分析结果.
主要方法:
- 在华沙医学大学,对42名多发性硬化症患者接受纳塔利祖马布治疗的回顾性图表审查.
- 根据PML风险分层算法,根据JCV指数水平 (<0.9,0.9-1.5,>1.5) 将患者分为分组.
- 收集的数据包括人口统计数据,疾病持续时间,纳塔利祖马布治疗持续时间,JCV指数,扩展残疾状态量表 (EDSS),以及使用延长间隔剂量 (EID) 和频繁的MRI.
主要成果:
- 在42名患者中,38%的患者的JCV指数大于1.5,这些患者的疾病持续时间更长,使用EID和MRI的频率更高.
- 发生了一例PML病例,但患者幸存下来并有所改善.
- 在JCV指数组之间没有观察到统计学上显著的人口差异,除了最高的JCV指数组的疾病持续时间.
结论:
- 在多发性硬化症患者中,长期使用纳塔利祖马布治疗似乎是安全的,患者的JCV指数为阳性.
- 实施预防措施,如延长剂量间隔和频繁的大脑MRI监测,对于这种患者群体的长期安全使用纳塔利祖马布至关重要.
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