Thomson Andrew
Core Medical Publishing, Knutsford, UK.
Core Evid. 2006;1(3):157-67. Epub 2006 Mar 31.
Multiple sclerosis is a demyelinating disease of the central nervous system which can cause severe disability and has profound effects on patients' quality of life over several decades. Although there is no cure for the disease, recently developed disease-modifying agents have modest effects on the impact of disease progression. There is therefore a need for a new, effective, and well-tolerated treatment for multiple sclerosis and FTY720 (an orally administered immunomodulatory compound with a novel mechanism of action) is one of a number of agents being evaluated for the treatment of this disease.
The objective of this article is to assess the therapeutic potential for FTY720, now in phase II clinical trials, for the treatment of multiple sclerosis through a review of the published evidence.
There is good evidence that FTY720 achieves immunomodulation as shown by a reversible redistribution of peripheral blood lymphocytes after oral administration. Two meeting abstracts have been published showing results obtained with FTY720 in a 12-month phase II clinical trial in patients with active relapsing multiple sclerosis. There is modest evidence that FTY720 significantly improves both patient-oriented (relapse rate) and disease-oriented outcomes (inflammatory disease activity). There is good evidence that FTY720 is well tolerated.
Based on these early results from the clinical development program, FTY720 has the potential to be an effective disease-modifying agent for the treatment of multiple sclerosis. Further results from ongoing multinational phase III studies are awaited.
多发性硬化症是一种中枢神经系统脱髓鞘疾病,可导致严重残疾,并在数十年间对患者的生活质量产生深远影响。尽管尚无治愈该疾病的方法,但最近研发的疾病修正药物对疾病进展的影响有一定作用。因此,需要一种新的、有效且耐受性良好的多发性硬化症治疗方法,而FTY720(一种具有新型作用机制的口服免疫调节化合物)是正在评估用于治疗该疾病的多种药物之一。
本文的目的是通过回顾已发表的证据,评估目前处于II期临床试验的FTY720治疗多发性硬化症的治疗潜力。
有充分证据表明,口服FTY720后外周血淋巴细胞可逆性重新分布,显示其具有免疫调节作用。已发表两篇会议摘要,展示了FTY720在复发型多发性硬化症患者的12个月II期临床试验中取得的结果。有一定证据表明,FTY720能显著改善以患者为导向的结果(复发率)和以疾病为导向的结果(炎症性疾病活动)。有充分证据表明,FTY720耐受性良好。
基于临床开发项目的这些早期结果,FTY720有潜力成为治疗多发性硬化症的有效疾病修正药物。正在进行的多国III期研究的进一步结果值得期待。