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那他珠单抗治疗可减轻多发性硬化症患者的疲劳。TYNERGY 试验的结果;真实环境下的一项研究。

Natalizumab treatment reduces fatigue in multiple sclerosis. Results from the TYNERGY trial; a study in the real life setting.

机构信息

Dept of Pharmacology and Clinical Neuroscience, Umeå University and University Hospital of Northern Sweden, Umeå, Sweden.

出版信息

PLoS One. 2013;8(3):e58643. doi: 10.1371/journal.pone.0058643. Epub 2013 Mar 21.

Abstract

UNLABELLED

Fatigue is a significant symptom in multiple sclerosis (MS) patients. First-generation disease modifying therapies (DMTs) are at best moderately effective to improve fatigue. Observations from small cohorts have indicated that natalizumab, an antibody targeting VLA-4, may reduce MS-related fatigue. The TYNERGY study aimed to further evaluate the effects of natalizumab treatment on MS-related fatigue. In this one-armed clinical trial including 195 MS patients, natalizumab was prescribed in a real-life setting, and a validated questionnaire, the Fatigue Scale for Motor and Cognitive functions (FSMC), was used both before and after 12 months of treatment to evaluate a possible change in the fatigue experienced by the patients. In the treated cohort all measured variables, that is, fatigue score, quality of life, sleepiness, depression, cognition, and disability progression were improved from baseline (all p values<0.0001). Walking speed as measured by the six-minute walk-test also increased at month 12 (p = 0.0016). All patients were aware of the nature of the treatment agent, and of the study outcomes.

CONCLUSION

Natalizumab, as used in a real-life setting, might improve MS-related fatigue based on the results from this one-armed un-controlled stud. Also other parameters related to patients' quality of life seemed to improve with natalizumab treatment.

TRIAL REGISTRATION

ClinicalTrials.gov NCT00884481.

摘要

未注明

疲劳是多发性硬化症(MS)患者的一个重要症状。第一代疾病修正疗法(DMT)充其量只能适度改善疲劳。来自小队列的观察结果表明,靶向 VLA-4 的抗体那他珠单抗可能会减轻 MS 相关的疲劳。TYNERGY 研究旨在进一步评估那他珠单抗治疗对 MS 相关疲劳的影响。在这项包括 195 名 MS 患者的单臂临床试验中,那他珠单抗在现实环境中被处方,使用经过验证的问卷,即运动和认知功能疲劳量表(FSMC),在治疗前和治疗 12 个月后评估患者所经历的疲劳变化。在治疗队列中,所有测量的变量,即疲劳评分、生活质量、嗜睡、抑郁、认知和残疾进展,均从基线开始改善(所有 p 值均<0.0001)。在 12 个月时,六分钟步行测试所测量的步行速度也有所提高(p = 0.0016)。所有患者都了解治疗药物的性质和研究结果。

结论

根据这项单臂非对照研究的结果,那他珠单抗在现实环境中的应用可能会改善 MS 相关的疲劳。此外,那他珠单抗治疗似乎还能改善与患者生活质量相关的其他参数。

试验注册

ClinicalTrials.gov NCT00884481。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/682a/3605436/7d43977a079f/pone.0058643.g001.jpg

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