Department of Health Sciences (DISSAL), University of Genoa, Via Pastore 1, Genoa 16132, Italy. mariapia.sormani@ unige.it
Nat Rev Neurol. 2013 Sep;9(9):504-12. doi: 10.1038/nrneurol.2013.146. Epub 2013 Jul 30.
The advent of a large number of new therapies for multiple sclerosis (MS) warrants the development of tools that enable selection of the best treatment option for each new patient with MS. Evidence from clinical trials clearly supports the efficacy of IFN-β for the treatment of MS, but few factors that predict a response to this drug in individual patients have emerged. This deficit might be due, at least in part, to the lack of a standardized definition of the clinical outcomes that signify improvement or worsening of the disease. MRI markers and clinical relapses have been the most widely studied short-term factors to predict long-term response to IFN-β, although the results are conflicting. Recently, integrated strategies combining MRI and clinical markers in scoring systems have provided a potentially useful approach for the management of patients with MS. In this Review, we focus on the many definitions of clinical response to IFN-β and explore the markers that can be used to predict this response. We also highlight advantages and limitations of the existing scoring systems in light of future expansion of these models to biological markers and to other classes of emerging therapies for MS.
多发性硬化症（MS）的大量新疗法的出现，需要开发工具来为每个新的 MS 患者选择最佳治疗方案。临床试验的证据清楚地表明 IFN-β 对 MS 的治疗有效，但在个体患者中预测对该药物反应的因素很少。这种缺陷可能至少部分归因于缺乏标准化的定义，来表示疾病的改善或恶化的临床结果。MRI 标志物和临床复发是预测 IFN-β 长期反应的最广泛研究的短期因素，尽管结果存在冲突。最近，将 MRI 和临床标志物结合在评分系统中的综合策略为 MS 患者的管理提供了一种潜在的有用方法。在这篇综述中，我们重点介绍了 IFN-β 临床反应的许多定义，并探讨了可用于预测这种反应的标志物。我们还根据这些模型对生物标志物和新兴 MS 治疗方法的其他类别进行扩展，突出了现有评分系统的优势和局限性。
