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1000例早期复发缓解型多发性硬化症患者的生活质量

Quality of life in 1000 patients with early relapsing-remitting multiple sclerosis.

作者信息

Putzki N, Fischer J, Gottwald K, Reifschneider G, Ries S, Siever A, Hoffmann F, Käfferlein W, Kausch U, Liedtke M, Kirchmeier J, Gmünd S, Richter A, Schicklmaier P, Niemczyk G, Wernsdörfer C, Hartung H P

机构信息

Department of Neurology, University Clinic Essen, University of Duisburg-Essen, Germany.

出版信息

Eur J Neurol. 2009 Jun;16(6):713-20. doi: 10.1111/j.1468-1331.2009.02572.x.

Abstract

BACKGROUND AND PURPOSE

To examine the quality of life (QoL) in a large cohort of untreated patients with relapsing-remitting multiple sclerosis (RRMS) and to investigate the impact of intramuscular (IM) interferon beta-1a (IFNbeta-1a) treatment.

METHODS

Prospective, observational, open-label, multicentre study conducted in Germany. Untreated patients with RRMS who initiated treatment with IM IFNbeta-1a were included and followed for 12 months. QoL was measured using the EQ-5D questionnaire. Clinical response was assessed by relapse rate and disability (Expanded Disability Status Scale; EDSS).

RESULTS

A total of 1157 patients were included [mean age 37.6 years, median disease duration 13 months, mean relapse rate 1.7 (95%CI: 1.58-1.73), median EDSS score 2.0]. Relapse rate was reduced to 0.6 at 12 months (95%CI: 0.51-0.69, P < 0.0001). EDSS did not change significantly. At baseline, QoL was considerably lower in MS patients compared with the general German population, but was improved after treatment initiation [utilities of EQ-5D: 0.77 (95%CI: 0.75-0.78) vs. 0.75 (95%CI: 0.74-0.76) at baseline, 95%CI for difference: 0.01-0.03, P = 0.0046]. Higher disease activity and inability to work were negative predictors of QoL. 14.7% of patients were incapable of working for MS-related reasons.

CONCLUSIONS

Quality of life is considerably impaired in early stages of MS. Treatment initiation with IM IFNbeta attenuates MS disease activity and improves QoL. Inability to work early during the disease is a major challenge for the social security systems.

摘要

背景与目的

研究一大群未经治疗的复发缓解型多发性硬化症(RRMS)患者的生活质量(QoL),并调查肌肉注射(IM)干扰素β-1a(IFNβ-1a)治疗的影响。

方法

在德国进行的前瞻性、观察性、开放标签、多中心研究。纳入开始接受IM IFNβ-1a治疗的未经治疗的RRMS患者,并随访12个月。使用EQ-5D问卷测量生活质量。通过复发率和残疾程度(扩展残疾状态量表;EDSS)评估临床反应。

结果

共纳入1157例患者[平均年龄37.6岁,疾病持续时间中位数13个月,平均复发率1.7(95%CI:1.58 - 1.73),EDSS评分中位数2.0]。12个月时复发率降至0.6(95%CI:0.51 - 0.69,P < 0.0001)。EDSS无显著变化。基线时,MS患者的生活质量与德国普通人群相比显著较低,但治疗开始后有所改善[EQ-5D效用值:基线时为0.77(95%CI:0.75 - 0.78),治疗后为0.75(95%CI:0.74 - 0.76),差异的95%CI:0.01 - 0.03,P = 0.0046]。较高的疾病活动度和无法工作是生活质量的负面预测因素。14.7%的患者因MS相关原因无法工作。

结论

MS早期生活质量受到严重损害。开始使用IM IFNβ治疗可减轻MS疾病活动度并改善生活质量。疾病早期无法工作对社会保障系统是一项重大挑战。

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