从诊断到治疗:在多发性硬化症中启动疾病修饰疗法的模式
Stefania Iaquinto1, Mina Stanikić2,3, Enriqueta Vallejo-Yagüe1
1Epidemiology, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.
Therapeutic advances in neurological disorders
|December 9, 2025
概括
在瑞士,多发性硬化症 (MS) 患者正在更早地开始疾病修饰疗法 (DMT),并选择更高效的治疗方法. 虽然这些先进的DMT显示了更少的可疑药物不良反应 (sADRs),但严重sADRs的潜在风险增加需要仔细考虑.
科学领域:
- 神经学 神经学
- 药理学 药理学是指药理学的学科.
- 公共卫生 公共卫生
背景情况:
- 多发性硬化症 (MS) 治疗已经转向早期高效疾病修饰疗法 (DMT).
- 瑞士的DMT启动模式和安全概况依赖于患者自我报告,仍未得到充分研究.
研究的目的:
- 分析从MS诊断到第一个DMT的时间.
- 研究初始DMT选择中的时间趋势.
- 在瑞士首次使用DMT后评估疑似药物不良反应 (sADRs) 和严重的sADRs.
主要方法:
- 追溯性队列研究,使用来自瑞士多发性硬化病登记 (1995-2024) 的纵向患者报告数据.
- 卡普兰-梅尔治疗时间分析,DMT使用趋势分析以及sADR和严重sADR的回归模型.
- 根据DMT开始时的性别和年龄进行了调整.
主要成果:
- 从诊断到第一次DMT的中位时间随着时间的推移显著减少.
- 最初的DMT使用从低效疗法转向高效疗法.
- 中度和高效的DMT与较少的SADR相关,但高效的DMT显示出非显著的趋势,导致更高的严重SADR风险.
结论:
- 患者的自我报告是可靠的跟踪DMT使用趋势在MS.
- 瑞士多发性硬化症患者更早开始使用DMT,并且随着时间的推移,效果更高.
- 在选择MS的第一线DMT时,平衡有效性和安全性至关重要,考虑到观察到的sADR配置文件.
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