Meca-Lallana Jose Eustasio, Hernández-Clares Rocío, Carreón-Guarnizo Ester
Department of Neurology, Multiple Sclerosis Unit, Hospital Clínico Universitario Virgen de la Arrixaca Carretera Madrid-Cartagena s/n, 30120, Murcia, Spain ; Cátedra de Neuroinmunología Clínica y Esclerosis Múltiple, UCAM Universidad Católica San Antonio de Murcia Campus de los Jerónimos, Guadalupe, 30107, Murcia, Spain.
Brain Behav. 2015 Sep;5(9):e00367. doi: 10.1002/brb3.367. Epub 2015 Jul 14.
Spasticity is one of the most disabling and difficult-to-treat symptoms shown by patients with multiple sclerosis, who often show a suboptimal and unsatisfactory response to classic treatment and new available nonpharmacological alternatives. Due to the progressive nature of this condition, the early management should be essential to improve long-term outcomes.
We performed a narrative literature review of the contribution of spasticity to the burden of multiple sclerosis and the potential role of classic disease-modifying drugs.
Added to the underlying pathophysiology of spasticity, certain external factors and drugs such as interferon may exacerbate the existing condition, hence their awareness is crucial as part of an effective management of spasticity. Furthermore, the evidence for the effectiveness of glatiramer acetate in preventing spasticity in naïve patients and in those switching from interferon should not be ignored.
This literature review proposes the examination of spasticity and the influence of classic disease-modifying agents on the level of existing condition among the variables to be considered when deciding on therapy for multiple sclerosis in clinical practice.
痉挛是多发性硬化症患者表现出的最致残且最难治疗的症状之一,这些患者对经典治疗方法和新的非药物替代疗法往往反应欠佳且不尽人意。由于这种疾病的进行性本质,早期管理对于改善长期预后至关重要。
我们对痉挛对多发性硬化症负担的影响以及经典疾病修饰药物的潜在作用进行了叙述性文献综述。
除了痉挛的潜在病理生理学外,某些外部因素和药物(如干扰素)可能会加重现有病情,因此,作为痉挛有效管理的一部分,认识到这些因素至关重要。此外,醋酸格拉替雷在预防初治患者和从干扰素转换过来的患者发生痉挛方面的有效性证据不容忽视。
这篇文献综述建议,在临床实践中决定多发性硬化症的治疗方案时,应将痉挛以及经典疾病修饰药物对现有病情的影响纳入需要考虑的变量之中进行检查。