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多发性硬化症的注射、输注和口服疾病修正治疗的治疗满意度。

Treatment satisfaction across injectable, infusion, and oral disease-modifying therapies for multiple sclerosis.

机构信息

Partners Multiple Sclerosis Center, Brigham and Women's Hospital, Boston, MA, USA.

Partners Multiple Sclerosis Center, Brigham and Women's Hospital, Boston, MA, USA; Department of Neurology, Harvard Medical School, Boston, MA, USA.

出版信息

Mult Scler Relat Disord. 2017 Nov;18:196-201. doi: 10.1016/j.msard.2017.10.002. Epub 2017 Oct 5.

Abstract

BACKGROUND

The recent approval of oral disease-modifying therapies (DMTs) for multiple sclerosis (MS) has provided patients with a new route of therapy administration. Little research has compared patients' experiences with and perceptions of injectable, infusion and oral MS therapies.

METHODS

Three hundred fifty-seven treated MS patients enrolled in the CLIMB study completed the Treatment Satisfaction Questionnaire for Medication (TSQM). The TSQM provides information regarding perceived effectiveness, side effects, convenience and overall satisfaction. The patients were treated with either interferon beta-1a intramuscular (IFNβ-1a IM) (n = 40), interferon beta-1a subcutaneous (IFNβ-1a SC) (n = 45), glatiramer acetate (GA) (n = 118), natalizumab (NTZ) (n = 44), fingolimod (n = 66), or dimethyl fumarate (BG-12) (n = 44). Multivariable linear regression models were used to compare treatment satisfaction across all DMTs and between patients treated with injectable (n = 203), infusion (n = 44), and oral (n = 110) DMTs. All models were adjusted for sex, age, EDSS, and time on treatment.

RESULTS

Patients taking oral DMTs reported significantly higher convenience scores compared to patients taking either injectable or infusion DMTs. The adjusted difference in the mean overall convenience score was 26.87 (95% CI: 21.4, 32.34) for the comparison of orals and injectables and 17.53 (95% CI: 11.15, 23.9) for the comparison of orals and infusion. In addition, the proportion of patients reporting a side effect was significantly lower for orals compared to injectables (adjusted OR= 0.35; 95% CI: 0.18, 0.68) and infusion compared to injectables (adjusted OR= 0.14; 95% CI: 0.05, 0.35).

CONCLUSION

Patients reported treatment with the oral medications as more convenient than the injectable and infusion DMTs.

摘要

背景

最近批准的多发性硬化症(MS)口服疾病修饰疗法(DMT)为患者提供了一种新的治疗途径。很少有研究比较过患者对注射、输注和口服 MS 治疗的体验和看法。

方法

357 名接受 CLIMB 研究治疗的 MS 患者完成了药物治疗满意度问卷(TSQM)。TSQM 提供了关于感知疗效、副作用、便利性和总体满意度的信息。这些患者接受了以下治疗:干扰素β-1a 肌内注射(IFNβ-1a IM)(n = 40)、干扰素β-1a 皮下注射(IFNβ-1a SC)(n = 45)、那他珠单抗(NTZ)(n = 44)、格拉替雷(GA)(n = 118)、芬戈莫德(n = 66)或富马酸二甲酯(BG-12)(n = 44)。多变量线性回归模型用于比较所有 DMT 之间的治疗满意度,并比较接受注射(n = 203)、输注(n = 44)和口服(n = 110)DMT 的患者之间的治疗满意度。所有模型均根据性别、年龄、EDSS 和治疗时间进行调整。

结果

服用口服 DMT 的患者报告便利性评分明显高于接受注射或输注 DMT 的患者。口服药物与注射药物相比,总体便利性评分的平均调整差异为 26.87(95%CI:21.4,32.34),口服药物与输注药物相比,便利性评分的平均调整差异为 17.53(95%CI:11.15,23.9)。此外,与注射药物相比,口服药物报告副作用的患者比例明显较低(调整后的 OR = 0.35;95%CI:0.18,0.68),与注射药物相比,口服药物报告副作用的患者比例明显较低(调整后的 OR = 0.14;95%CI:0.05,0.35)。

结论

患者报告说,与注射和输注 DMT 相比,他们服用口服药物的治疗更方便。

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