Portaccio E, Zipoli V, Siracusa G, Sorbi S, Amato M P
Department of Neurology, University of Florence, Florence, Italy.
Eur Neurol. 2008;59(3-4):131-5. doi: 10.1159/000111875. Epub 2007 Nov 30.
BACKGROUND/AIMS: To assess the proportion and the reasons of drop-outs in relapsing-remitting multiple sclerosis patients treated with interferon-beta (IFNB) and the outcome of switching subjects.
Patients stopping IFNB were classified according to the reason of drop-out: perceived lack of efficacy (PLE) side effects (SE) and other reasons. Long-term adherence was described using the Kaplan-Meier curves.
We evaluated 225 subjects (158 women; age = 36.6 +/- 9.2 years, disease duration = 8.0 +/- 6.1 years, Expanded Disability Status Scale score = 1.9 +/- 1.2) who received Betaferon (46), Avonex (88) and Rebif (91) therapy. The mean follow-up duration was 4.2 +/- 2.7 years. Forty-six percent of patients suspended therapy, 29% because of PLE, 15% because of SE and the remaining 2% due to other reasons. Twenty-five out of 33 subjects who suspended IFNB because of SE and 62 out of 65 patients who suspended the therapy due to PLE were switched to another disease-modifying drug. At the end of the follow-up, the majority of these patients could continue the treatment.
When starting IFNB therapy in relapsing-remitting multiple sclerosis, a relatively high proportion of discontinuation is to be expected over time. Switching from a treatment to another taking into account the reasons of drop-out and the disease activity is a suitable option.
背景/目的：评估接受β-干扰素（IFNB）治疗的复发缓解型多发性硬化症患者的停药比例及原因，以及换药患者的转归情况。
根据停药原因对停用IFNB的患者进行分类：认为疗效不佳（PLE）、副作用（SE）及其他原因。采用Kaplan-Meier曲线描述长期依从性。
我们评估了225例接受β-干扰素（46例）、阿沃尼单抗（88例）和利比（91例）治疗的患者（158例女性；年龄=36.6±9.2岁，病程=8.0±6.1年，扩展残疾状态量表评分=1.9±1.2）。平均随访时间为4.2±2.7年。46%的患者中止治疗，29%是因为疗效不佳，15%是因为副作用，其余2%是由于其他原因。33例因副作用停用IFNB的患者中有25例，65例因疗效不佳停用治疗的患者中有62例换用了另一种疾病修饰药物。随访结束时，这些患者中的大多数能够继续治疗。
在复发缓解型多发性硬化症患者开始IFNB治疗时，随着时间推移预计会有相对较高比例的停药情况。考虑停药原因和疾病活动情况从一种治疗换用另一种治疗是一个合适的选择。
