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一种群体方法来表征干扰素β-1b对复发缓解型多发性硬化症患者强化病灶的影响。

A Population Approach to Characterize Interferon Beta-1b Effect on Contrast Enhancing Lesions in Patients With Relapsing Remitting Multiple Sclerosis.

作者信息

Gulati A, Bagnato F, Villoslada P, Velez de Mendizabal N

机构信息

Indiana University School of Medicine Indianapolis, Indiana, USA ; Indiana Clinical and Translational Sciences Institute (CTSI) Indianapolis, Indiana, USA.

Neuroimmunology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health Bethesda, Maryland, USA.

出版信息

CPT Pharmacometrics Syst Pharmacol. 2015 May;4(5):295-304. doi: 10.1002/psp4.36. Epub 2015 Apr 24.

Abstract

In patients with relapsing-remitting multiple sclerosis (RRMS), interferon beta-1b (IFNβ-1b) reduces the occurrence of contrast enhancing lesions (CELs) on magnetic resonance imaging (MRI). Questions remain on the stability of IFNβ-1b effect over time and its action beyond the reduction of CELs. In this study, we described the IFNβ-1b effect by a mixed effects model, quantifying the interpatient variability associated with its parameters. Using a negative binomial distribution model as a natural history model, the effect of IFNβ-1b was evaluated using different mathematical functions of time. IFNβ-1b produced a decrease in the expected CEL numbers, inhibiting the formation of new CELs but did not promote the resolution of the already-formed ones. Based on the final selected model, simulations were carried out to optimize the combined IFNβ-1b-corticosteroid therapy as a proof-of-concept. In summary, we provide evidence on the dynamics of CELs under IFNβ-1b treatment that can be used to monitor the effects of therapies in MS.

摘要

在复发缓解型多发性硬化症(RRMS)患者中,干扰素β-1b(IFNβ-1b)可减少磁共振成像(MRI)上强化病灶(CELs)的出现。关于IFNβ-1b疗效随时间的稳定性及其在减少CELs之外的作用,仍存在疑问。在本研究中,我们通过混合效应模型描述了IFNβ-1b的疗效,量化了与其参数相关的患者间变异性。使用负二项分布模型作为自然史模型,通过时间的不同数学函数评估IFNβ-1b的疗效。IFNβ-1b使预期的CEL数量减少,抑制了新CELs的形成,但并未促进已形成CELs的消退。基于最终选定的模型,进行了模拟以优化IFNβ-1b与皮质类固醇联合治疗,作为概念验证。总之,我们提供了IFNβ-1b治疗下CELs动态变化的证据,可用于监测MS治疗的效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/82d2/4452935/7b8aaa752d50/psp40004-0295-f1.jpg

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