Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Biological and Diagnostic Sciences, Faculty of Dentistry, University of Toronto, Toronto, Canada.
Psychiatry Clin Neurosci. 2015 Oct;69(10):649-57. doi: 10.1111/pcn.12308. Epub 2015 Jun 1.
The aim of this study was to evaluate the effect of various disease-modifying therapies (DMT) on quality of life in multiple sclerosis (MS).
This was a three-arm parallel study with balanced randomization in which 90 newly diagnosed, definite MS subjects referred to Ghaem Medical Center, Mashhad, Iran were enrolled between 2006 and 2009. Patients were randomly allocated into three DMT groups: Avonex, Rebif and Betaferon. Health-related quality of life was assessed in MS patients at baseline and 12 months after treatment with DMT using the MS Quality of Life-54 questionnaire.
Both mental and physical health scores improved within all three treatment groups after 12 months of treatment; however, this increase was only significant in the mental health composite in the Betaferon group (P = 0.024). Betaferon had the highest mental health score change (14.04) while this change was 7.26 for Avonex (P = 0.031) and 5.08 for Rebif (P = 0.017). A physical health composite score comparison among the three treatment groups revealed no significant results.
With a positive impact of DMT on mental and physical dimensions of QOL in MS patients, initiation of treatment soon after diagnosis is recommended. In MS patients with more mental issues and fewer physical disabilities, Betaferon might be considered as a better choice of treatment.
本研究旨在评估各种疾病修正疗法（DMT）对多发性硬化症（MS）患者生活质量的影响。
这是一项三臂平行研究，采用平衡随机分组，2006 年至 2009 年期间共有 90 名新诊断的、明确的 MS 患者被纳入盖姆医疗中心，伊朗马什哈德。患者被随机分配到三个 DMT 组：Avonex、Rebif 和 Betaferon。在开始 DMT 治疗后 12 个月，使用 MS 生活质量-54 问卷评估 MS 患者的健康相关生活质量。
在所有三个治疗组中，治疗 12 个月后，心理健康和身体健康评分均有所提高；然而，贝伐单抗组的心理健康综合评分仅显著增加（P = 0.024）。贝伐单抗的心理健康评分变化最大（14.04），而 Avonex 为 7.26（P = 0.031），Rebif 为 5.08（P = 0.017）。三组治疗间的生理健康综合评分比较无显著差异。
DMT 对 MS 患者的心理健康和身体健康维度的生活质量有积极影响，建议在诊断后尽快开始治疗。对于精神问题较多、身体残疾较少的 MS 患者，贝伐单抗可能是更好的治疗选择。
