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醋酸格拉替雷在初治和既往接受β-1b干扰素治疗的多发性硬化症患者中的应用

Glatiramer acetate in treatment-naïve and prior interferon-beta-1b-treated multiple sclerosis patients.

作者信息

Zwibel H L

机构信息

Multiple Sclerosis Center, Baptist/Health Doctors' Hospital, Coral Gables, FL, USA.

出版信息

Acta Neurol Scand. 2006 Jun;113(6):378-86. doi: 10.1111/j.1600-0404.2006.00627.x.

Abstract

OBJECTIVE

This prospective, open-label study evaluated the efficacy, safety, and tolerability of glatiramer acetate (GA) in treatment-naïve relapsing-remitting multiple sclerosis (RRMS) patients and in patients who had previously received interferon-beta (IFN-beta)-1b therapy.

METHODS

Two treatment cohorts were defined based on prestudy IFN-beta-1b use. At entry, prior IFN-beta-1b patients (n = 247) were older, had longer disease duration, and had higher mean Expanded Disability Status Scale (EDSS) scores, relapse rates, and ambulation indexes than treatment-naïve patients (n = 558). Safety was assessed every 3 months and EDSS every 6 months for up to 3.5 years.

RESULTS

Overall, 247 treatment-naïve and 107 prior IFN-beta-1b patients discontinued before study end. Median GA treatment durations were 36 and 24 months in treatment-naïve and prior IFN-beta-1b patients, respectively. At last observation, annual relapse rates had declined by 75% in both cohorts (0.42 +/- 0.84 and 0.34 +/- 0.71 in treatment-naïve and prior IFN-beta-1b groups, respectively, P = 0.1482). Mean changes in EDSS were less than 0.5 in both cohorts, regardless of entry EDSS, at 12 and 18 months and at last observation.

CONCLUSIONS

Prior IFN-beta-1b treatment does not negatively influence the efficacy, safety, or tolerability of subsequent GA therapy. Switching to GA can benefit patients who discontinue IFN-beta therapy.

摘要

目的

本前瞻性、开放标签研究评估了醋酸格拉替雷(GA)在初治复发缓解型多发性硬化症(RRMS)患者以及先前接受过β-干扰素(IFN-β)-1b治疗的患者中的疗效、安全性和耐受性。

方法

根据研究前是否使用IFN-β-1b定义了两个治疗队列。入组时,先前使用IFN-β-1b的患者(n = 247)比初治患者(n = 558)年龄更大、病程更长,且平均扩展残疾状态量表(EDSS)评分、复发率和步行指数更高。每3个月评估一次安全性,每6个月评估一次EDSS,最长评估3.5年。

结果

总体而言,247例初治患者和107例先前使用IFN-β-1b的患者在研究结束前停药。初治患者和先前使用IFN-β-1b的患者中,GA治疗的中位持续时间分别为36个月和24个月。在最后一次观察时,两个队列的年复发率均下降了75%(初治组和先前使用IFN-β-1b组分别为0.42±0.84和0.34±0.71,P = 0.1482)。在12个月、18个月和最后一次观察时,无论入组时的EDSS如何,两个队列的EDSS平均变化均小于0.5。

结论

先前的IFN-β-1b治疗不会对后续GA治疗的疗效、安全性或耐受性产生负面影响。换用GA可使停用IFN-β治疗的患者受益。

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