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在复发性多发性硬化症的复发性形式的二线治疗中,退出策略模式

Ali Rezaei¹, Nasim Rezaeimanesh¹, Kosar Kohandel¹

¹Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.

Acta neurologica Belgica

|January 30, 2026

概括

患有复发性复发性多发性硬化症 (RRMS) 的患者切换二线疗法,往往转向像ocrelizumab这样的B细胞耗尽治疗. 这些转变可以导致提高残疾分数,特别是在由于效率不足而转换时.

科学领域:

神经学神经学
免疫学免疫学免疫学
临床研究临床研究

背景情况:

复发性复发性多发性硬化症 (RRMS) 的管理经常需要由于安全性,疗效或患者因素而调整治疗.
在切换或停止使用纳塔利祖马布和奥克雷祖马布等先进疗法后,对结局的现实数据仍然有限.

研究的目的:

分析第二线治疗的RRMS患者的治疗过渡模式和中止原因.
在切换或停止二线RRMS治疗后六个月评估临床和MRI结果.

主要方法:

一项回顾性队列研究,涉及伊朗德黑兰锡纳医院的338名RRMS患者.
临床和MRI参数的数据是在治疗改变后的基线和六个月随访时收集的.
评估的结果包括复发频率,扩展残疾状态量表 (EDSS) 变化和MRI病变活性.

主要成果:

最常见的治疗转换目的地是ocrelizumab (42.3%) 和rituximab (33.4%).
转换的主要原因包括安全问题 (32.0%) 和效率不足 (29.9%).
从fingolimod转换为ocrelizumab的小组显示出显著的EDSS减少 (平均差异0.19,p=0.019);由于疗效不足而转换的患者也显示出显著的EDSS改善 (平均差异0.25,p<0.001).

结论:

消耗B细胞的疗法,尤其是ocrelizumab,显示出减少活跃RRMS中的残疾的潜力.
个性化治疗策略平衡有效性,安全性和患者因素对于管理RRMS至关重要.
需要进一步的前性研究来确认这些治疗过渡的长期益处.

关键词:

用B细胞治疗方法.关于EDSS的结果在RRMS中使用RRMS.第二线的DMT是二线的DMT 停止治疗停止治疗

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