MS4 Research Institute, Ubbergseweg 34, 6522 KJ Nijmegen, the Netherlands.
Health Qual Life Outcomes. 2010 Nov 15;8:133. doi: 10.1186/1477-7525-8-133.
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.
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.
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).
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.
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。
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。
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。
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。