Servicio de Inmunologia Clinica, Hospital Clinico San Carlos, Instituto de Investigacion Sanitaria del Hospital Clinico San Carlos (IdISSC), 28040 Madrid, Spain.
Red Espanola de Esclerosis Multiple (REEM), Fondo de Investigacion Sanitaria, Instituto de Salud Carlos III, Ministerios de Economia y Competitividad, Madrid, Spain.
Curr Med Chem. 2018;25(27):3272-3283. doi: 10.2174/0929867325666180226105612.
In the 1990s, the beta interferons and glatiramer acetate were introduced for treating relapsing-remitting multiple sclerosis. These medications have a demonstrated record of efficacy and safety, although they require frequent administration via injection and are only partially effective. The optimization of treatment in patients who do not respond adequately to this first-line therapy is essential for attaining the best long-term outcomes. Switching to the recently approved emergent therapies is a strategy to consider for treatment of patients with a suboptimal response.
This review summarizes the mechanisms of action, clinical benefits, and safety profiles of current multiple sclerosis disease-modifying therapies, including highly efficacious monoclonal antibodies or convenient oral therapies, and with a special focus on the pegylated interferon beta 1a formulation.
We reviewed the recent literature and human clinical trials on multiple sclerosis therapies by bibliographic search in PubMed and clinicaltrials.gov.
Although the first-line interferon beta exhibits a favorable benefit-torisk profile, treatment compliance is compromised potentially due to its known adverse events and frequent injectable administration. Less frequent dosing and improved pharmacological properties have been achieved by reaction of interferon beta with chemically activated polyethylene glycol. Provided that none of the available therapies show better effectiveness for all outcomes and their safety in clinical practice is of a fundamental concern, the pegylated form of interferon beta seems to keep its place as a competitive therapeutic option.
20 世纪 90 年代,β干扰素和醋酸格拉替雷被引入用于治疗复发缓解型多发性硬化症。这些药物已被证明具有疗效和安全性,但需要频繁注射,且仅部分有效。对于那些对一线治疗反应不佳的患者,优化治疗至关重要,以实现最佳的长期结果。对于反应不佳的患者,转换为最近批准的新兴疗法是一种值得考虑的治疗策略。
本综述总结了当前多发性硬化症疾病修正治疗药物的作用机制、临床获益和安全性概况,包括高效单克隆抗体或方便的口服治疗药物,特别关注聚乙二醇化干扰素β 1a 制剂。
我们通过在 PubMed 和 clinicaltrials.gov 上进行文献检索,回顾了多发性硬化症治疗的最新文献和人类临床试验。
虽然一线干扰素β表现出良好的获益-风险比,但由于其已知的不良反应和频繁的注射给药,治疗依从性受到影响。通过干扰素β与化学激活的聚乙二醇反应,实现了更频繁的给药和改善的药理学特性。在没有任何一种现有疗法在所有结局上都显示出更好的有效性且其在临床实践中的安全性至关重要的情况下,聚乙二醇化干扰素β似乎仍然是一种具有竞争力的治疗选择。