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两种β-干扰素治疗复发缓解型多发性硬化症的随机研究。

A randomized study of two interferon-beta treatments in relapsing-remitting multiple sclerosis.

作者信息

Koch-Henriksen N, Sørensen P S, Christensen T, Frederiksen J, Ravnborg M, Jensen K, Heltberg A, Kristensen O, Stenager E, Petersen T, Hansen T

机构信息

Danish Multiple Sclerosis Registry, Rigshospitalet, Copenhagen, Denmark.

出版信息

Neurology. 2006 Apr 11;66(7):1056-60. doi: 10.1212/01.wnl.0000204018.52311.ec. Epub 2006 Mar 1.

Abstract

OBJECTIVE

To investigate whether the efficacy of interferon-beta (IFNbeta) treatment of relapsing-remitting MS (RR-MS) was influenced by type, dose, and frequency of administration.

METHODS

From June 1996 through October 1997, the authors offered participation to all Danish RR-MS patients who met the following criteria: definite MS, at least two relapses within 2 years, age 18 to 55, and an Expanded Disability Status Scale (EDSS) score of < or = 5.5. The study was multicenter, controlled, open-label, randomized, head-to-head comparing IFNbeta-1a 22 microg once a week (n = 143) with IFNbeta-1b 250 microg every other day (n = 158), both subcutaneously, for 24 months. Patients who declined randomization were offered treatment with IFNbeta-1b 250 microg every other day (n = 120). The primary end-points were the annualized relapse rate, the time to first relapse, and neutralizing antibody formation. The secondary endpoint was time to sustained progression.

RESULTS

The annual relapse rates were virtually equal in the two arms of the randomized study (IFNbeta-1a: 0.70; IFNbeta-1b: 0.71); so were the time to first relapse and the time to sustained progression. In the nonrandomized patients (IFNbeta-1b), the annual relapse rate was not significantly different, but the time to progression was shorter.

CONCLUSION

In this study, 250 microg interferon-beta-1b administered every other day did not prove clinically superior to once-a-week administration of 22 microg interferon-beta-1a.

摘要

目的

研究β-干扰素(IFNβ)治疗复发缓解型多发性硬化症(RR-MS)的疗效是否受给药类型、剂量和频率的影响。

方法

从1996年6月至1997年10月,作者邀请所有符合以下标准的丹麦RR-MS患者参与研究:确诊为MS,2年内至少两次复发,年龄18至55岁,扩展残疾状态量表(EDSS)评分≤5.5。该研究为多中心、对照、开放标签、随机、头对头比较,将22μg的IFNβ-1a每周一次皮下注射(n = 143)与250μg的IFNβ-1b每隔一天皮下注射(n = 158),持续24个月。拒绝随机分组的患者接受250μg的IFNβ-1b每隔一天皮下注射(n = 120)。主要终点为年化复发率、首次复发时间和中和抗体形成。次要终点为持续进展时间。

结果

随机研究的两组年化复发率几乎相等(IFNβ-1a:0.70;IFNβ-1b:0.71);首次复发时间和持续进展时间也是如此。在非随机分组的患者(IFNβ-1b)中,年化复发率无显著差异,但进展时间较短。

结论

在本研究中,每隔一天给予250μg的IFNβ-1b在临床上并未证明优于每周一次给予22μg的IFNβ-1a。

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