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多发性硬化和结性脊髓炎患者的治疗挑战:一个案例系列

Lucas P Garfinkel¹, Judy Diep², Anjela Anand³

¹Cooper Medical School of Rowan University, Camden, NJ 08103, USA.

Multiple sclerosis and related disorders

|December 14, 2025

概括

同时的多发性硬化症 (MS) 和结性脊柱炎 (AS) 是罕见的. 一种IL-17A抑制剂Secukinumab,与TNF抑制剂不同,在不恶化MS的情况下显示出AS治疗的希望.

科学领域:

神经免疫学神经免疫学
类风湿病学类风湿病学
自免疫性疾病自免疫性疾病

背景情况:

多发性硬化症 (MS) 是一种慢性免疫媒介疾病,全球影响超过200万.
与MS一起报告了像SLE这样的同时发生的自身免疫性疾病,但与性脊髓炎 (AS) 相关的MS很少见.
由于某些疗法的禁忌,如MS中TNF-α抑制剂 (TNFi),同时发生的MS和AS的管理具有挑战性.

研究的目的:

描述患有同时存在多发性硬化和AS的患者.
审查有关MS和AS联合诊断的文献.
专注于管理这些并发性疾病的治疗挑战.

主要方法:

三名患有MS和AS的患者的病例系列.
发表的病例报告的综合文献综述.
对临床和治疗数据的分析.

主要成果:

在18例病例中,复发性复发性多发性硬化症是最常见的亚型 (15例已发表,3例新).
在所有八名AS患者中,TNF抑制剂 (TNFi) 已因脱髓化问题而停止使用.
在没有MS恶化的5名患者中,secukinumab (IL-17A抑制剂) 耐受性良好,对AS有效.

结论:

同时出现的MS和AS可能会呈现出不同的临床和实验室特征.
针对更活跃的疾病,优先选择向免疫疗法.
双重免疫抑制只适用于高度活跃的MS和AS病例.

关键词:

结性脊柱炎是一种疾病.抗-TNF-α免疫疗法免疫疗法同时存在的自身免疫性疾病.改变疾病的治疗方法.多发性硬化症是多发性硬化症.

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