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侧向切换至 IFN beta-1a 44 mcg 可能与 fingolimod 一样有效,适用于在特定复发缓解型多发性硬化症患者中进行升级治疗:来自真实世界环境的经验。

Lateral switch to IFN beta-1a 44 mcg may be effective as escalation switch to fingolimod in selected persons with relapsing remitting multiple sclerosis: a real-world setting experience.

机构信息

a Department "G.F. Ingrassia"; MS center , University of Catania , Catania , Italy.

出版信息

Expert Rev Clin Pharmacol. 2018 May;11(5):531-536. doi: 10.1080/17512433.2018.1449643. Epub 2018 Mar 13.

Abstract

BACKGROUND

The efficacy of lateral and escalation switch is a challenge in MS. We compared in a real-world setting the efficacy of switching to IFN beta-1a 44 mcg or to fingolimod in persons with relapsing remitting MS (pwRRMS) who failed with others injectable IFNs or glatiramer acetate.

RESEARCH DESIGN AND METHODS

retrospective analysis of 24 months prospectively-collected data at the MS center of the University of Catania, Italy was performed. Patients who were switched to IFN-beta 1a 44 mcg or fingolimod were analyzed using propensity-score covariate adjustment model within demographic (e.g. age and gender) and disease (e.g. timing of pre-switch relapse) characteristics. Switching-time was considered the starting-time of the observation.

RESULTS

43 pwRRMS on IFN beta-1a 44 mcg and 49 pwRRMS on fingolimod were included. Baseline characteristics differed for EDSS score and number of T2 lesions (higher in group on fingolimod). At 24 months of follow up, both groups showed no differences in the survival curves of reaching a first new relapse, new T2 and Gd+ MRI brain lesions, even corrected for the propensity score covariate adjustment.

CONCLUSIONS

lateral switch to IFN beta-1a 44 mcg and escalation switch to fingolimod showed same ability in influencing RRMS disease activity at 24 months.

摘要

背景

在多发性硬化症(MS)中,侧向转换和升级转换的疗效是一个挑战。我们在意大利卡塔尼亚大学的 MS 中心进行了一项真实世界研究,比较了在其他注射用干扰素或那他珠单抗治疗失败的复发缓解型多发性硬化症(pwRRMS)患者中,转换为 IFN beta-1a 44 mcg 或 fingolimod 的疗效。

研究设计和方法

对意大利卡塔尼亚大学 MS 中心前瞻性收集的 24 个月数据进行回顾性分析。使用倾向评分协变量调整模型,对转换为 IFN-beta 1a 44 mcg 或 fingolimod 的患者进行分析,协变量包括人口统计学特征(如年龄和性别)和疾病特征(如转换前复发的时间)。转换时间被认为是观察的起始时间。

结果

纳入了 43 名接受 IFN beta-1a 44 mcg 治疗和 49 名接受 fingolimod 治疗的 pwRRMS 患者。两组患者的基线特征在 EDSS 评分和 T2 病变数量方面存在差异(fingolimod 组更高)。在 24 个月的随访中,两组在首次新发复发、新 T2 和 Gd+MRI 脑病变的生存曲线方面均无差异,即使经过倾向评分协变量调整也是如此。

结论

侧向转换为 IFN beta-1a 44 mcg 和升级转换为 fingolimod 在 24 个月时对 RRMS 疾病活动的影响相同。

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