Neurologia 2-CRESM, AOU San Luigi, Orbassano, Italy.
Neurol Sci. 2014 Feb;35(2):307-16. doi: 10.1007/s10072-013-1616-1. Epub 2013 Dec 29.
Interferon beta (IFNβ) was the first specific disease-modifying treatment licensed for relapsing-remitting multiple sclerosis, and is still one of the most commonly prescribed treatments. A strong body of evidence supports the effectiveness of IFNβ preparations in reducing the annual relapse rate, magnetic resonance (MRI) disease activity and disease progression. However, the development of binding/neutralizing antibodies (BAbs/NAbs) during treatment negatively affects clinical and MRI outcomes. Therefore, guidelines for the clinical use for the detection of NAbs in MS may result in better treatment of these patients. In October 2012, a panel of Italian neurologists from 17 MS clinics convened in Milan to review and discuss data on NAbs and their clinical relevance in the treatment of MS. In this paper, we report the panel's recommendations for the use of IFNβ Nabs detection in the early identification of IFNβ non-responsiveness and the management of patients on IFNβ treatment in Italy, according to a model of therapeutically appropriate care.
干扰素 β(IFNβ)是第一个被批准用于治疗复发缓解型多发性硬化症的特异性疾病修正治疗药物,也是目前最常被开处方的治疗药物之一。大量证据支持 IFNβ 制剂在降低年度复发率、磁共振成像(MRI)疾病活动度和疾病进展方面的有效性。然而,在治疗过程中产生的结合/中和抗体(BAbs/NAbs)会对临床和 MRI 结果产生负面影响。因此,检测 MS 中 NAbs 的临床使用指南可能会导致这些患者得到更好的治疗。2012 年 10 月,来自意大利 17 个多发性硬化症诊所的一组意大利神经病学家在米兰开会,审查和讨论了关于 NAbs 及其在 MS 治疗中的临床相关性的数据。在本文中,我们根据治疗性适当护理的模式,报告了专家组关于在意大利使用 IFNβ NAbs 检测来早期识别 IFNβ 无应答和管理 IFNβ 治疗患者的建议。