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多发性硬化症中疾病修饰疗法与抑郁症之间的关系。

Relationship between disease-modifying therapy and depression in multiple sclerosis.

作者信息

Kirzinger Stephen S, Jones Jason, Siegwald Angela, Crush Andrew Bryce

机构信息

University of Louisville School of Medicine, Louisville, KY, USA (SSK, AS, ABC); and Intermountain Healthcare, Salt Lake City, UT, USA (JJ). Dr. Kirzinger is now with Quintiles, CNS Therapeutic Delivery Unit, San Diego, CA, USA.

出版信息

Int J MS Care. 2013 Fall;15(3):107-12. doi: 10.7224/1537-2073.2012-036.

Abstract

Many prescribers of disease-modifying therapies (DMTs) for multiple sclerosis (MS) believe that interferon beta (IFNβ) is more likely than glatiramer acetate (GA) to increase depression during the course of MS treatment. Therefore, newly diagnosed patients with a history of depression are often placed on GA therapy from the onset of MS treatment. The aim of this study was to examine the relationship between DMT type and depression among patients with relapsing-remitting MS (RRMS). Patients with RRMS who were examined from 2000 to 2007 and who remained on a single course of therapy (either an IFNβ or GA) were included in a retrospective review of medical records. Patients were asked to complete the Beck Depression Inventory (BDI) at treatment initiation and every 6 months thereafter for up to 4 years. Only patients who had completed a BDI within 6 weeks of starting their DMT were included in the analysis. No significant differences in mean change in BDI score were observed from baseline to 48 months between the IFNβ and GA subgroups. Additionally, no significant differences in mean BDI score change were observed between antidepressant-treated and non-antidepressant-treated patients within the IFNβ or GA subgroup. Neither IFNβ nor GA therapy appears to exacerbate depressive symptoms in patients with RRMS who remain on their initial therapy.

摘要

许多为多发性硬化症(MS)开具疾病修正疗法(DMT)的医生认为,在MS治疗过程中,干扰素β(IFNβ)比醋酸格拉替雷(GA)更有可能增加抑郁症状。因此,新诊断出有抑郁病史的患者在MS治疗开始时通常会接受GA治疗。本研究的目的是探讨复发缓解型MS(RRMS)患者中DMT类型与抑郁之间的关系。对2000年至2007年接受检查且一直接受单一疗程治疗(IFNβ或GA)的RRMS患者的病历进行回顾性分析。要求患者在治疗开始时以及此后每6个月完成一次贝克抑郁量表(BDI),持续4年。分析仅纳入在开始DMT治疗后6周内完成BDI的患者。IFNβ和GA亚组从基线到48个月的BDI评分平均变化无显著差异。此外,在IFNβ或GA亚组中,接受抗抑郁治疗和未接受抗抑郁治疗的患者之间BDI评分变化也无显著差异。对于继续接受初始治疗的RRMS患者,IFNβ和GA治疗似乎均不会加重抑郁症状。

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