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在使用醋酸格拉替雷治疗复发性缓解型多发性硬化症患者期间的健康相关生活质量:一项前瞻性、观察性、国际性、多中心研究。

Health-related quality of life in relapsing remitting multiple sclerosis patients during treatment with glatiramer acetate: a prospective, observational, international, multi-centre study.

机构信息

MS4 Research Institute, Ubbergseweg 34, 6522 KJ Nijmegen, the Netherlands.

出版信息

Health Qual Life Outcomes. 2010 Nov 15;8:133. doi: 10.1186/1477-7525-8-133.

Abstract

BACKGROUND

Glatiramer acetate (GA) and interferon-beta (INFb) are first-line disease modifying drugs for relapsing remitting multiple sclerosis (RRMS). Treatment with INFb is associated with a significant increase in health-related quality of life (HR-QoL) in the first 12 months. It is not known whether HR-QoL increases during treatment with GA.

METHODS

197 RRMS patients, 106 without and 91 with prior immunomodulation/immunosuppression, were studied for HR-QoL (Leeds Multiple Sclerosis-QoL [LMS-QoL] scale, score range 0 - 32), fatigue (Fatigue Impact Scale [FIS]) and depressed mood (Beck Depression Inventory-Short Form [BDI-SF]) at baseline and 6 and 12 months after start of GA treatment.

RESULTS

At 6 and 12 months mean LMS-QoL scores were significantly increased in the treatment-naive patient group (p < 0.001), not in the pre-treated group. At month 12 43% of treatment-naïve patients had improved HR-QoL (increase LMS-QoL score 3 or more points) (p < 0.001). Likewise, mean FIS scores were decreased at months 6 and 12 in the treatment-naïve group (p < 0.01), not in the pre-treated group. In both groups mean BDI-SF scores did not change. No demographic or clinical baseline factor was predictive of HR-QoL increase. HR-QoL changes were zero to negative for patients who had discontinued GA before month 12 (28.4% of patients).

CONCLUSIONS

In RRMS patients without prior immunomodulation/immunosuppression treatment with GA was associated with an increase in HR-QoL in the first 6 months, that was sustained at 12 months. In 4 out of 10 patients HR-QoL improved. Increase in HR-QoL was associated with decrease in fatigue.

摘要

背景

醋酸格拉替雷(GA)和干扰素-β(INFb)是治疗复发缓解型多发性硬化症(RRMS)的一线疾病修正药物。在最初的 12 个月内,使用 INFb 治疗与健康相关的生活质量(HR-QoL)显著提高。目前尚不清楚 GA 治疗期间 HR-QoL 是否会增加。

方法

研究了 197 例 RRMS 患者,其中 106 例无免疫调节/免疫抑制治疗史,91 例有免疫调节/免疫抑制治疗史,采用利兹多发性硬化症生活质量量表(LMS-QoL 量表,评分范围 0-32)、疲劳量表(疲劳影响量表[FIS])和抑郁情绪量表(贝克抑郁量表短表[BDI-SF])评估患者的 HR-QoL、疲劳和抑郁情绪。在 GA 治疗开始后 6 个月和 12 个月时对患者进行评估。

结果

在无治疗史的患者组中,治疗 6 个月和 12 个月时 LMS-QoL 评分均显著升高(p < 0.001),而在有治疗史的患者组中未升高。在第 12 个月时,43%的无治疗史患者 HR-QoL 改善(LMS-QoL 评分增加 3 分或以上)(p < 0.001)。同样,在无治疗史的患者组中,FIS 评分在治疗 6 个月和 12 个月时均降低(p < 0.01),而在有治疗史的患者组中未降低。在两个患者组中,BDI-SF 评分均未发生变化。在无治疗史的患者中,没有任何人口统计学或临床基线因素可预测 HR-QoL 改善。在第 12 个月前停止 GA 治疗的患者(占患者总数的 28.4%),HR-QoL 变化为零至负向。

结论

在无免疫调节/免疫抑制治疗史的 RRMS 患者中,GA 治疗在最初的 6 个月内与 HR-QoL 提高相关,12 个月时仍保持这一趋势。在 10 名患者中,有 4 名患者的 HR-QoL 得到改善。HR-QoL 的提高与疲劳的减轻相关。

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