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干扰素β-1b对日本复发缓解型多发性硬化症患者有效:一项随机、多中心研究。

Interferon beta-1b is effective in Japanese RRMS patients: a randomized, multicenter study.

作者信息

Saida T, Tashiro K, Itoyama Y, Sato T, Ohashi Y, Zhao Z

机构信息

Department of Neurology, Utano National Hospital, Kyoto, Japan.

出版信息

Neurology. 2005 Feb 22;64(4):621-30. doi: 10.1212/01.WNL.0000151856.10387.E2.

DOI:10.1212/01.WNL.0000151856.10387.E2
PMID:15728282
Abstract

OBJECTIVE

To assess the efficacy of interferon beta-1b (IFNB-1b) in Japanese patients with relapsing-remitting multiple sclerosis (RRMS).

BACKGROUND

The effects of IFNB in RRMS have been assessed in study populations comprised predominantly of white patients. MS in Japanese patients is different from that in white patients in that there are two different presentations--classic MS (C-MS) and optic-spinal MS (OS-MS)--and chronic progressive forms are infrequent.

METHODS

A total of 205 Japanese patients with RRMS were randomized to receive 50 microg or 250 microg (1.6 or 8.0 MIU) IFNB-1b administered SC every other day for up to 2 years. The primary endpoint was annual relapse rate. Secondary endpoints included further relapse-related and MRI outcome measures, as well as changes in Expanded Disability Status Scale and Neurologic Rating Scale. Efficacy was assessed in 188 patients, and safety was assessed in 192 patients. Supplemental ad hoc subgroup analyses were also performed for patients with OS-MS and those with C-MS.

RESULTS

Annual relapse rates were 0.763 in the 250 microg group and 1.069 in the 50 microg group, a relative reduction of 28.6% (p = 0.047). Results for all secondary endpoints favored 250 microg IFNB-1b. Subgroup analyses suggested that the magnitude and direction of treatment effect in patients with OS-MS and C-MS was similar, albeit not significant due to small sample size.

CONCLUSIONS

Interferon beta-1b (IFNB-1b) 250 microg significantly reduced relapse rates and change in MRI lesion area in Japanese patients with relapsing-remitting multiple sclerosis, and seemed to be comparably effective in optic-spinal multiple sclerosis (MS) and classic MS. The response to treatment with IFNB-1b in Japanese patients with MS suggests that a common pathogenesis and underlying genetic characteristics are shared with white patients.

摘要

目的

评估β-1b干扰素(IFNB-1b)对日本复发缓解型多发性硬化症(RRMS)患者的疗效。

背景

IFNB对RRMS疗效的评估主要在以白人患者为主的研究人群中进行。日本患者的MS与白人患者不同,有两种不同表现形式——经典型MS(C-MS)和视神经脊髓型MS(OS-MS),慢性进展型较少见。

方法

共205例日本RRMS患者被随机分为两组,分别隔日皮下注射50μg或250μg(1.6或8.0 MIU)IFNB-1b,持续2年。主要终点为年复发率。次要终点包括进一步的复发相关指标和MRI结果指标,以及扩展残疾状态量表和神经功能评分量表的变化。对188例患者评估疗效,对192例患者评估安全性。还对OS-MS患者和C-MS患者进行了补充性特设亚组分析。

结果

250μg组的年复发率为0.763,50μg组为1.069,相对降低了28.6%(p = 0.047)。所有次要终点结果均支持250μg的IFNB-1b。亚组分析表明,OS-MS患者和C-MS患者的治疗效果大小和方向相似,尽管由于样本量小而无显著差异。

结论

250μg的β-1b干扰素(IFNB-1b)可显著降低日本复发缓解型多发性硬化症患者的复发率和MRI病灶面积变化,对视神经脊髓型多发性硬化症(MS)和经典型MS似乎同样有效。日本MS患者对IFNB-1b治疗的反应表明,其与白人患者具有共同的发病机制和潜在遗传特征。

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