Borges Isabela T, Shea Colin D, Ohayon Joan, Jones Blake C, Stone Roger D, Ostuni John, Shiee Navid, McFarland Henry, Bielekova Bibiana, Reich Daniel S
National Institute of Neurological Disorders and Stroke, National Institutes of Health, USA.
Mult Scler Relat Disord. 2013 Apr 1;2(2):133-140. doi: 10.1016/j.msard.2012.10.002.
Daclizumab is a monoclonal antibody that reduces inflammation in multiple sclerosis (MS). Through a retrospective analysis, our objective was to determine whether daclizumab treatment reduces the rate of brain structure atrophy in comparison to a mixture of other disease-modifying therapies (mainly different interferon β preparations). We analyzed MRI examinations (1332 scans from 70 MS cases) obtained between 2000 and 2011 in a single center and processed with an automated brain segmentation method. We used mixed-effects multivariable linear regression models to determine whether a median of 4.3 years of daclizumab therapy in 26 patients altered rates of brain-volume change, controlling for variations in MRI protocol. The control group consisted of 44 patients not treated with daclizumab. We found that supratentorial brain volume declined by 5.17 ml per year (95% confidence limits: 3.58-6.77) off daclizumab therapy. On daclizumab, the annual rate of volume loss decreased to 3.72 ml (=0.01). The rate of ventricular enlargement decreased from 1.26 to 0.42 ml per year (<0.001). Focused analysis suggests that reduction in gray matter atrophy rate most likely underlies these results. In summary, in this retrospective analysis, daclizumab therapy substantially decreased the rate of brain atrophy in relapsing-remitting MS in comparison to other disease-modifying therapies, predominantly interferon β.
达克珠单抗是一种可减轻多发性硬化症（MS）炎症的单克隆抗体。通过一项回顾性分析，我们的目的是确定与其他多种疾病改善疗法（主要是不同的干扰素β制剂）相比，达克珠单抗治疗是否能降低脑结构萎缩率。我们分析了2000年至2011年在单一中心获得的MRI检查结果（来自70例MS患者的1332次扫描），并采用自动脑分割方法进行处理。我们使用混合效应多变量线性回归模型来确定26例患者接受中位数为4.3年的达克珠单抗治疗是否改变了脑容量变化率，并控制MRI检查方案的差异。对照组由44例未接受达克珠单抗治疗的患者组成。我们发现，在未使用达克珠单抗治疗时，幕上脑容量每年下降5.17 ml（95%置信区间：3.58 - 6.77）。使用达克珠单抗后，年容量损失率降至3.72 ml（P = 0.01）。脑室扩大率从每年1.26 ml降至0.42 ml（P < 0.001）。重点分析表明，灰质萎缩率的降低很可能是这些结果的基础。总之，在这项回顾性分析中，与其他疾病改善疗法（主要是干扰素β）相比，达克珠单抗治疗显著降低了复发缓解型MS的脑萎缩率。
