Arnal-García Carmen, Amigo-Jorrin Maria Del Campo, López-Real Ana Maria, Lema-Devesa Carme, Llopis Noemi, Sanchez-de la Rosa R
Neurology Service, Hospital Universitario Virgen de las Nieves, Avenida Juan Pablo II, S/N, 18013 Granada, Spain.
Neurology Department, Complexo Hospitalario de Pontevedra, Pontevedra, Spain.
J Clin Neurosci. 2014 Dec;21(12):2212-8. doi: 10.1016/j.jocn.2014.05.045. Epub 2014 Sep 23.
Glatiramer acetate currently represents one of the main treatments for relapsing-remitting multiple sclerosis (RRMS). However, the information available about its long-term effect in clinical practice is still limited. Thus, this multicenter retrospective cohort study aimed to assess the long-term effectiveness of glatiramer acetate in this setting. The study population included RRMS patients treated with glatiramer acetate for at least 5 years after its marketing authorization and the primary endpoint was long-term clinical effectiveness, defined as absence of disability progression for at least five consecutive years. A total of 149 patients were included into the study, who had received glatiramer acetate for a mean of 6.9 ± 1.4 years (5 years, n=149; 6 years, n=112; 7 years, n=63; 8 years, n=32; 9 years, n=21). More than 85% of patients remained free from disability progression through years 1 to 9 of glatiramer acetate treatment, and 75.2% showed absence of disability progression for at least five consecutive years. Expanded Disability Status Scale (EDSS) scores were maintained, with most patients showing stable/improved EDSS and 92.6% sustaining EDSS <6. Decreased annual relapse rates and increased proportion of relapse-free patients were maintained during the whole glatiramer acetate treatment compared to the year prior to its authorization (p<0.001). The number of gadolinium-enhanced T1-weighted lesions also decreased from pre-glatiramer-acetate assessment to last follow-up whilst on glatiramer acetate (p<0.05). In conclusion, administration of glatiramer acetate shows long-term clinical effectiveness for RRMS treatment; its effect under clinical practice conditions slowed disability progression and reduced relapse occurrence for up to 9 years.
醋酸格拉替雷目前是复发缓解型多发性硬化症(RRMS)的主要治疗方法之一。然而,关于其在临床实践中的长期效果的现有信息仍然有限。因此,这项多中心回顾性队列研究旨在评估醋酸格拉替雷在这种情况下的长期有效性。研究人群包括在醋酸格拉替雷获得上市许可后接受至少5年治疗的RRMS患者,主要终点是长期临床有效性,定义为至少连续五年无残疾进展。共有149名患者纳入研究,他们接受醋酸格拉替雷治疗的平均时间为6.9±1.4年(5年,n = 149;6年,n = 112;7年,n = 63;8年,n = 32;9年,n = 21)。在醋酸格拉替雷治疗的第1至9年,超过85%的患者没有残疾进展,75.2%的患者至少连续五年无残疾进展。扩展残疾状态量表(EDSS)评分保持稳定,大多数患者的EDSS稳定/改善,92.6%的患者EDSS<6。与获得许可前一年相比,在整个醋酸格拉替雷治疗期间,年复发率降低,无复发患者比例增加(p<0.001)。从醋酸格拉替雷治疗前评估到最后一次随访,钆增强T1加权病灶数量也减少(p<0.05)。总之,醋酸格拉替雷给药对RRMS治疗显示出长期临床有效性;其在临床实践条件下的效果减缓了残疾进展,并在长达9年内减少了复发的发生。