Li Rui, Sun Xiaobo, Shu Yaqing, Mao Zhifeng, Xiao Li, Qiu Wei, Lu Zhengqi, Hu Xueqiang
Department of Neurology, The Third Affiliated Hospital of Sun Yet-senYet-sen University, Guangzhou, China.
Department of Neurology, The Third Affiliated Hospital of Sun Yet-senYet-sen University, Guangzhou, China.
Mult Scler Relat Disord. 2017 Feb;12:23-28. doi: 10.1016/j.msard.2017.01.001. Epub 2017 Jan 3.
Multiple sclerosis (MS) is a chronic immune mediated demyelinating disease of the central nervous system that exhibits sexual dimorphism and may benefit from sex-specific treatment. To investigate a potential influence of sex on immunomodulatory therapeutic effects in patients with MS, we performed a comprehensive analysis of published studies examining sex differences in the effects of disease-modifying treatments (DMTs) for MS.
PubMed, Cochrane Library, and Web of Science databases were searched for clinical studies involving patients with MS who were undergoing DMTs. Studies were included if they investigated sex differences in DMT outcomes.
Fourteen studies with 11,425 participants were included; 11 of these studies were randomized controlled trials, and 3 were cohort studies. Although the studies did occasionally show sex-specific differences for some clinical outcomes in patients with MS who received DMTs, the limitation of subgroup analysis design made it difficult to draw conclusions on the direction or the extent of the sex-based effect.
No clear sex-based differences in response to DMTs have been documented to date. More studies will be needed to better elucidate the presence of sex differences on the DMT effects.
多发性硬化症（MS）是一种慢性免疫介导的中枢神经系统脱髓鞘疾病，存在性别差异，可能从针对性别的治疗中获益。为了研究性别对MS患者免疫调节治疗效果的潜在影响，我们对已发表的研究进行了全面分析，这些研究考察了疾病修饰治疗（DMTs）对MS的疗效中的性别差异。
在PubMed、Cochrane图书馆和科学网数据库中检索涉及接受DMTs治疗的MS患者的临床研究。如果研究调查了DMT结果中的性别差异，则将其纳入。
纳入了14项研究，共11425名参与者；其中11项研究为随机对照试验，3项为队列研究。尽管这些研究偶尔显示接受DMTs治疗的MS患者在某些临床结果上存在性别特异性差异，但亚组分析设计的局限性使得难以就基于性别的效应方向或程度得出结论。
迄今为止，尚未记录到DMTs反应中存在明确的性别差异。需要更多研究来更好地阐明DMT效果上性别差异的存在情况。
