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日常临床实践中多发性硬化症患者对干扰素-β长期反应的1年预测评分的验证

Validation of 1-year predictive score of long-term response to interferon-β in everyday clinical practice multiple sclerosis patients.

作者信息

Romeo M, Martinelli V, Rodegher M, Perego E, Maida S, Sormani M P, Comi G

机构信息

Division of Neuroscience, Department of Neurology, Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute, Milan, Italy.

出版信息

Eur J Neurol. 2015 Jun;22(6):973-80. doi: 10.1111/ene.12695. Epub 2015 Apr 6.

Abstract

BACKGROUND AND PURPOSE

The Rio score (RS) and the modified Rio score (MRS) are two scoring systems that can identify the early predictive factors of disability progression in relapsing-remitting multiple sclerosis (RRMS) patients treated with interferon-β (IFN-β). The objective of the study was to validate the usefulness of the RS and MRS in a large cohort of multiple sclerosis patients treated with IFN-β in daily clinical practice.

METHODS

The analysis included a cohort of RRMS patients treated with different formulations of IFN-β for at least 1 year. The RS and MRS were used to classify the patients after 1 year of treatment. Multivariate analysis was performed to identify predictive variables of suboptimal response at 5 years, defined as Expanded Disability Status Scale confirmed progression or switching to a second-line therapy.

RESULTS

Sixty-nine of 416 included patients were considered as suboptimal responders at 5-year evaluation. The possible score range was 0-3. A higher risk of suboptimal response was found for RS and MRS in the presence of ≥2 scores (hazard ratio 3.0, P = 0.002, and hazard ratio 5.0, P < 0.0001, respectively).

CONCLUSIONS

Our study confirmed, in a daily clinical setting, that MRS had a better specificity and accuracy than RS in identifying the patients who will have a poor response to long-term IFN-β treatment.

摘要

背景与目的

里约评分(RS)和改良里约评分(MRS)是两种评分系统,可用于识别接受干扰素-β(IFN-β)治疗的复发缓解型多发性硬化症(RRMS)患者残疾进展的早期预测因素。本研究的目的是在日常临床实践中,验证RS和MRS在一大群接受IFN-β治疗的多发性硬化症患者中的有效性。

方法

分析纳入了一组接受不同剂型IFN-β治疗至少1年的RRMS患者。在治疗1年后,使用RS和MRS对患者进行分类。进行多变量分析以确定5年时反应欠佳的预测变量,反应欠佳定义为扩展残疾状态量表确认病情进展或改用二线治疗。

结果

在416例纳入患者中,69例在5年评估时被视为反应欠佳者。可能的评分范围为0至3分。当RS和MRS评分≥2分时,出现反应欠佳的风险更高(风险比分别为3.0,P = 0.002;以及5.0,P < 0.0001)。

结论

我们的研究在日常临床环境中证实,在识别对长期IFN-β治疗反应不佳的患者方面,MRS比RS具有更好的特异性和准确性。

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