美国神经科医生对临床孤立综合征、复发缓解型多发性硬化症或风险不确定的患者的诊疗模式：一项共识研究。
Practice patterns of US neurologists in patients with CIS, RRMS, or RIS: A consensus study.
作者信息
Tornatore Carlo, Phillips J Theodore, Khan Omar, Miller Aaron E, Barnes Christopher J
机构信息
Georgetown University Hospital (CT), Washington, DC; Baylor Institute for Immunology Research (JTP), Dallas, TX; Wayne State University School of Medicine (OK), Detroit, MI; Mount Sinai School of Medicine (AEM), New York, NY; and Infusion Communications (CJB), Haddam, CT.
出版信息
Neurol Clin Pract. 2012 Mar;2(1):48-57. doi: 10.1212/CPJ.0b013e31824cb09b.
Abstract
We assess current practice patterns of US neurologists in patients with clinically isolated syndrome (CIS), relapsing-remitting multiple sclerosis (RRMS), and radiologically isolated syndrome (RIS) using case-based surveys. For CIS, 87% recommended initiation of disease-modifying therapy (DMT) with MRI brain lesions. An injectable DMT was recommended by 90%-98% for treatment-naive, mild RRMS patients. There was 97% consensus to treat highly active RRMS, but no consensus on therapy choice. With RIS, there was consensus not to initiate treatment with brain but no spinal MRI lesions. Current US treatment patterns emphasize MRI in MS diagnosis and subsequent treatment decisions, treatment of early disease, aggressive initial treatment of highly active MS, and close patient monitoring.
摘要
我们通过基于病例的调查评估了美国神经科医生对临床孤立综合征（CIS）、复发缓解型多发性硬化症（RRMS）和放射学孤立综合征（RIS）患者的当前治疗模式。对于CIS，87%的医生建议在脑部出现MRI病变时开始使用疾病修正治疗（DMT）。对于未接受过治疗的轻度RRMS患者，90%-98%的医生推荐使用注射用DMT。对于高度活跃的RRMS患者，97%的医生达成了治疗共识，但在治疗方案选择上没有达成共识。对于RIS，在脑部无病变但脊髓有MRI病变的情况下，医生们达成了不开始治疗的共识。美国目前的治疗模式强调在MS诊断和后续治疗决策中使用MRI、早期疾病的治疗、对高度活跃MS的积极初始治疗以及对患者的密切监测。
相似文献
1
Practice patterns of US neurologists in patients with CIS, RRMS, or RIS: A consensus study.美国神经科医生对临床孤立综合征、复发缓解型多发性硬化症或风险不确定的患者的诊疗模式：一项共识研究。
Neurol Clin Pract. 2012 Mar;2(1):48-57. doi: 10.1212/CPJ.0b013e31824cb09b.
2
Consensus opinion of US neurologists on practice patterns in RIS, CIS, and RRMS: Evolution of treatment practices.美国神经科医生对临床孤立综合征、临床孤立症和复发缓解型多发性硬化症实践模式的共识意见：治疗实践的演变
Neurol Clin Pract. 2016 Aug;6(4):329-338. doi: 10.1212/CPJ.0000000000000254.
3
Clinical practice patterns in multiple sclerosis management: Mexican consensus recommendations.多发性硬化症管理的临床实践模式：墨西哥共识建议。
Mult Scler Relat Disord. 2021 Aug;53:103053. doi: 10.1016/j.msard.2021.103053. Epub 2021 May 30.
4
Survey of diagnostic and treatment practices for multiple sclerosis in Europe.欧洲多发性硬化症诊断与治疗实践调查。
Eur J Neurol. 2017 Mar;24(3):516-522. doi: 10.1111/ene.13236. Epub 2017 Jan 31.
5
Survey of diagnostic and treatment practices for multiple sclerosis in Russian Federation in comparison to European data.俄罗斯联邦多发性硬化症诊断和治疗实践的调查与欧洲数据的比较。
Mult Scler Relat Disord. 2021 Oct;55:103201. doi: 10.1016/j.msard.2021.103201. Epub 2021 Aug 8.
6
Evaluation of diagnosis and treatment practices of Brazilian neurologists among patients with multiple sclerosis.评估巴西神经病学家对多发性硬化症患者的诊断和治疗实践。
Arq Neuropsiquiatr. 2021 Jul;79(7):598-606. doi: 10.1590/0004-282X-ANP-2020-0362.
7
Improving the characterization of radiologically isolated syndrome suggestive of multiple sclerosis.提高对疑似多发性硬化症的影像学孤立综合征的特征描述。
PLoS One. 2011 Apr 29;6(4):e19452. doi: 10.1371/journal.pone.0019452.
8
Radiologically isolated syndrome: A single-center, retrospective cohort study.放射学孤立综合征：一项单中心回顾性队列研究。
Mult Scler Relat Disord. 2021 Oct;55:103183. doi: 10.1016/j.msard.2021.103183. Epub 2021 Aug 2.
9
Cerebrospinal fluid chitinase-3-like protein 1 level is not an independent predictive factor for the risk of clinical conversion in radiologically isolated syndrome.脑脊髓液几丁质酶-3 样蛋白 1 水平不是孤立影像学综合征患者临床转化风险的独立预测因素。
Mult Scler. 2019 Apr;25(5):669-677. doi: 10.1177/1352458518767043. Epub 2018 Mar 22.
10
Decision-making on radiologically isolated syndrome among Argentinean neurologists: A survey based on clinical experience.阿根廷神经科医生对影像学孤立综合征的决策：基于临床经验的调查。
Mult Scler Relat Disord. 2019 Jan;27:61-64. doi: 10.1016/j.msard.2018.09.030. Epub 2018 Oct 2.
引用本文的文献
1
Early Disease-Modifying Treatments for Presymptomatic Multiple Sclerosis.早期疾病修饰治疗用于多发性硬化症的无症状期。
CNS Drugs. 2024 Dec;38(12):973-983. doi: 10.1007/s40263-024-01117-9. Epub 2024 Sep 16.
2
Real-World Treatment of Patients with Multiple Sclerosis per MS Subtype and Associated Healthcare Resource Use: An Analysis Based on 13,333 Patients in Germany.根据德国13333例患者分析多发性硬化症各亚型患者的真实世界治疗情况及相关医疗资源使用情况
Neurol Ther. 2020 Jun;9(1):67-83. doi: 10.1007/s40120-019-00172-5. Epub 2019 Dec 12.
3
Practice patterns of US neurologists in patients with SPMS and PPMS: A consensus study.美国神经科医生对继发进展型多发性硬化症和原发进展型多发性硬化症患者的诊疗模式：一项共识研究。
Neurol Clin Pract. 2012 Dec;2(4):265-266.
4
Practice patterns of US neurologists in patients with SPMS and PPMS: A consensus study.美国神经科医生对继发进展型多发性硬化症和原发进展型多发性硬化症患者的诊疗模式：一项共识研究。
Neurol Clin Pract. 2012 Dec;2(4):265-266. doi: 10.1212/CPJ.0b013e3182789e04.
5
Modeling Approaches in Cost-Effectiveness Analysis of Disease-Modifying Therapies for Relapsing-Remitting Multiple Sclerosis: An Updated Systematic Review and Recommendations for Future Economic Evaluations.疾病修正治疗缓解复发型多发性硬化症的成本效益分析中的建模方法：更新的系统评价和对未来经济评估的建议。
Pharmacoeconomics. 2018 Oct;36(10):1223-1252. doi: 10.1007/s40273-018-0683-9.
6
Consensus opinion of US neurologists on practice patterns in RIS, CIS, and RRMS: Evolution of treatment practices.美国神经科医生对临床孤立综合征、临床孤立症和复发缓解型多发性硬化症实践模式的共识意见：治疗实践的演变
Neurol Clin Pract. 2016 Aug;6(4):329-338. doi: 10.1212/CPJ.0000000000000254.
7
Factors associated with benign multiple sclerosis in the New York State MS Consortium (NYSMSC).纽约州多发性硬化症联盟（NYSMSC）中与良性多发性硬化症相关的因素。
BMC Neurol. 2016 Jul 15;16:102. doi: 10.1186/s12883-016-0623-2.
8
Paediatric Multiple Sclerosis: Update on Diagnostic Criteria, Imaging, Histopathology and Treatment Choices.儿童多发性硬化症：诊断标准、影像学、组织病理学及治疗选择的最新进展
Curr Neurol Neurosci Rep. 2016 Jul;16(7):68. doi: 10.1007/s11910-016-0663-4.
9
Nonconventional MRI biomarkers for in vivo monitoring of pathogenesis in multiple sclerosis.用于多发性硬化症发病机制体内监测的非传统 MRI 生物标志物。
Neurol Neuroimmunol Neuroinflamm. 2014 Nov 20;1(4):e45. doi: 10.1212/NXI.0000000000000045. eCollection 2014 Dec.
本文引用的文献
1
MRI monitoring of immunomodulation in relapse-onset multiple sclerosis trials.MRI 监测复发缓解型多发性硬化症临床试验中的免疫调节作用。
Nat Rev Neurol. 2011 Dec 6;8(1):13-21. doi: 10.1038/nrneurol.2011.190.
2
3
Revised McDonald criteria: the persisting importance of cerebrospinal fluid analysis.修订的麦克唐纳标准：脑脊液分析的持续重要性
Ann Neurol. 2011 Sep;70(3):520; author reply 521. doi: 10.1002/ana.22508. Epub 2011 Jun 27.
4
Comparison of fingolimod with interferon beta-1a in relapsing-remitting multiple sclerosis: a randomised extension of the TRANSFORMS study.在复发缓解型多发性硬化症中比较芬戈莫德与干扰素 β-1a：TRANSFORMS 研究的随机扩展。
Lancet Neurol. 2011 Jun;10(6):520-9. doi: 10.1016/S1474-4422(11)70099-0. Epub 2011 May 13.
5
Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria.多发性硬化症的诊断标准：2010 年麦克唐纳标准修订版。
Ann Neurol. 2011 Feb;69(2):292-302. doi: 10.1002/ana.22366.
6
Asymptomatic spinal cord lesions predict disease progression in radiologically isolated syndrome.无症状性脊髓病变可预测孤立影像学综合征的疾病进展。
Neurology. 2011 Feb 22;76(8):686-92. doi: 10.1212/WNL.0b013e31820d8b1d. Epub 2011 Jan 26.
7
Treatment effects of immunomodulatory therapies at different stages of multiple sclerosis in short-term trials.多发性硬化症短期试验中不同阶段免疫调节疗法的治疗效果。
Neurology. 2011 Jan 4;76(1 Suppl 1):S14-25. doi: 10.1212/WNL.0b013e3182050388.
8
Oral therapies for multiple sclerosis: a review of agents in phase III development or recently approved.多发性硬化症的口服疗法：处于 III 期开发或最近批准的药物综述。
CNS Drugs. 2011 Jan;25(1):37-52. doi: 10.2165/11539820-000000000-00000.
9
Fingolimod is a potential novel therapy for multiple sclerosis.芬戈莫德是一种多发性硬化症的潜在新型疗法。
Nat Rev Neurol. 2010 Jul;6(7):373-82. doi: 10.1038/nrneurol.2010.76. Epub 2010 Jun 15.
10
MRI criteria for MS in patients with clinically isolated syndromes.MRI 标准用于诊断临床孤立综合征患者的多发性硬化症。
Neurology. 2010 Feb 2;74(5):427-34. doi: 10.1212/WNL.0b013e3181cec45c. Epub 2010 Jan 6.
Zotero 插件