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克拉屈滨对复发型多发性硬化患者生活质量的积极影响。

Positive impact of cladribine on quality of life in people with relapsing multiple sclerosis.

机构信息

Blizard Institute (Neuroscience), Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.

ITS Research, Queen Mary University of London, London, UK.

出版信息

Mult Scler. 2018 Oct;24(11):1461-1468. doi: 10.1177/1352458517726380. Epub 2017 Aug 17.

Abstract

BACKGROUND

A number of elements of the pivotal 'cladribine tablets treating multiple sclerosis orally' (CLARITY) trial have remained unpublished.

OBJECTIVE

To report the impact of cladribine on health-related quality of life (QoL) in people with relapsing multiple sclerosis (pwRMS).

METHODS

QoL data from the phase III trial of two different doses (3.5 and 5.25 mg/kg) of oral cladribine in pwRMS were acquired from the European Medicines Agency through Freedom of Information. Spearman's rank correlation was used to analyse the relationship between baseline QoL scores and baseline Expanded Disability Status Scale (EDSS) scores. Responses of the Euro Quality of Life 5 Dimensions (EQ-5D) and Multiple Sclerosis Quality of Life-54 (MSQOL-54) questionnaires were compared between treatment and control groups using univariate analyses of covariance.

RESULTS

In total, n = 5148 EQ-5D responses and n = 894 MSQOL-54 physical, mental health and dimension scores were extracted. Baseline EQ-5D indices correlated with EDSS scores. After 2 years, pwRMS taking 3.5 ( p = .001) and 5.25 mg/kg ( p = .022) reported significantly improved EQ-5D index scores compared with placebo. Positive, yet non-significant, differences were detected in MSQOL-54 scores between cladribine and placebo.

CONCLUSION

Analysis of the CLARITY dataset suggests that, over and above its established clinical efficacy, cladribine leads to improved QoL over 96 weeks. ClinicalTrials.gov identifier: NCT00213135.

摘要

背景

关键性“克拉屈滨片剂口服治疗多发性硬化症”(CLARITY)试验的一些内容仍未公布。

目的

报告克拉屈滨对复发型多发性硬化症(pwRMS)患者健康相关生活质量(QoL)的影响。

方法

通过信息自由,从欧洲药品管理局获得了两项不同剂量(3.5 和 5.25mg/kg)克拉屈滨口服治疗 pwRMS 的 III 期试验的 QoL 数据。采用 Spearman 秩相关分析来分析基线 QoL 评分与基线扩展残疾状况量表(EDSS)评分之间的关系。采用单变量协方差分析比较治疗组和对照组之间 EuroQol 五维健康量表(EQ-5D)和多发性硬化生活质量量表-54(MSQOL-54)问卷的应答情况。

结果

共提取了 n=5148 份 EQ-5D 应答和 n=894 份 MSQOL-54 躯体健康、心理健康和维度评分。基线 EQ-5D 指数与 EDSS 评分相关。在 2 年时,pwRMS 服用 3.5mg/kg(p=0.001)和 5.25mg/kg(p=0.022)与安慰剂相比,EQ-5D 指数评分显著改善。克拉屈滨与安慰剂相比,MSQOL-54 评分也有正向但无统计学意义的差异。

结论

对 CLARITY 数据集的分析表明,除了已确立的临床疗效外,克拉屈滨还可在 96 周内改善 QoL。临床试验.gov 标识符:NCT00213135。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9ddf/6174629/c7f6fd8e8909/10.1177_1352458517726380-fig1.jpg

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