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基于社区的复发型多发性硬化症患者队列中持续长期使用β-1a干扰素的结果。

Results of sustained long-term use of interferon beta-1a in a community-based cohort of patients with relapsing multiple sclerosis.

作者信息

Cohan Stanley, Chen Chiayi, Baraban Elizabeth, Stuchiner Tamela, Grote Lois, Rodriguez Monica

机构信息

Providence Health and Services, Multiple Sclerosis Center, Portland, OR, USA.

Providence Health and Services, Brain and Spine Institute, Portland, OR, USA.

出版信息

J Drug Assess. 2015 Feb 7;4(1):1-6. doi: 10.3109/21556660.2015.1010650. eCollection 2015.

Abstract

BACKGROUND

Few studies have evaluated long-term efficacy of interferon beta-1a in large community-based cohorts.

OBJECTIVE

Evaluate time to relapse, relapse rate, and disability progression in patients treated with intramuscular interferon beta-1a.

METHODS

A retrospective review of medical records from 2000-2010 was performed. Adult patients with relapsing-remitting MS or clinically isolated syndrome treated with interferon beta-1a were included. Primary outcomes were time to relapse, annualized relapse rate, and changes in Expanded Disability Status Scale score. Other outcomes included factors associated with time to first relapse, risk of having a relapse while receiving interferon beta-1a, and discontinuation of therapy.

RESULTS

In total, 364 of 696 patients screened were enrolled, with a mean age of 51 ± 12.1 years, disease duration of 9.39 ± 7.02 years, and duration of therapy of 4.03 ± 2.56 years. Mean time to first on-therapy relapse was 5.58 ± 0.26 years, annualized relapse rate was 0.30 ± 0.55 years, and mean increase in sustained Expanded Disability Status Scale score was 0.018. Relapse risk was associated with higher baseline Expanded Disability Status Scale score, age at disease onset, and number of relapses in the 12 months prior to therapy initiation.

CONCLUSIONS

This study demonstrates favorable clinical outcomes observed in a large community-based cohort, and serves to emphasize the continued therapeutic importance of interferon beta-1a, despite the development of newer agents with greater convenience of use, but also more potential risk of serious morbidity.

摘要

背景

很少有研究评估基于大型社区队列的干扰素β-1a的长期疗效。

目的

评估接受肌肉注射干扰素β-1a治疗的患者的复发时间、复发率和残疾进展情况。

方法

对2000年至2010年的病历进行回顾性分析。纳入接受干扰素β-1a治疗的复发缓解型多发性硬化症或临床孤立综合征的成年患者。主要结局指标为复发时间、年化复发率和扩展残疾状态量表评分的变化。其他结局指标包括与首次复发时间相关的因素、接受干扰素β-1a治疗期间复发的风险以及治疗中断情况。

结果

总共696名筛查患者中有364名入组,平均年龄为51±12.1岁,病程为9.39±7.02年,治疗时间为4.03±2.56年。首次治疗后复发的平均时间为5.58±0.26年,年化复发率为0.30±0.55年,扩展残疾状态量表持续评分的平均增加为0.018。复发风险与更高的基线扩展残疾状态量表评分、疾病发病年龄以及治疗开始前12个月内的复发次数相关。

结论

本研究表明在一个大型社区队列中观察到了良好的临床结局,并强调了干扰素β-1a持续的治疗重要性,尽管出现了使用更方便但严重发病潜在风险更高的新型药物。

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