Havrdová Eva, Arnold Douglas L, Bar-Or Amit, Comi Giancarlo, Hartung Hans-Peter, Kappos Ludwig, Lublin Fred, Selmaj Krzysztof, Traboulsee Anthony, Belachew Shibeshih, Bennett Iain, Buffels Regine, Garren Hideki, Han Jian, Julian Laura, Napieralski Julie, Hauser Stephen L, Giovannoni Gavin
Department of Neurology and Center for Clinical Neuroscience, Charles University, Czech Republic.
Department of Neurology and Neurosurgery, McGill University, Canada.
Mult Scler J Exp Transl Clin. 2018 Mar 12;4(1):2055217318760642. doi: 10.1177/2055217318760642. eCollection 2018 Jan-Mar.
No evidence of disease activity (NEDA; defined as no 12-week confirmed disability progression, no protocol-defined relapses, no new/enlarging T2 lesions and no T1 gadolinium-enhancing lesions) using a fixed-study entry baseline is commonly used as a treatment outcome in multiple sclerosis (MS).
The objective of this paper is to assess the effect of ocrelizumab on NEDA using re-baselining analysis, and the predictive value of NEDA status.
NEDA was assessed in a modified intent-to-treat population ( = 1520) from the pooled OPERA I and OPERA II studies over various epochs in patients with relapsing MS receiving ocrelizumab (600 mg) or interferon beta-1a (IFN β-1a; 44 μg).
NEDA was increased with ocrelizumab vs IFN β-1a over 96 weeks by 75% ( < 0.001), from Week 0‒24 by 33% ( < 0.001) and from Week 24‒96 by 72% ( < 0.001). Among patients with disease activity during Weeks 0‒24, 66.4% vs 24.3% achieved NEDA during Weeks 24‒96 in the ocrelizumab and IFN β-1a groups (relative increase: 177%; < 0.001).
Superior efficacy with ocrelizumab compared with IFN β-1a was consistently seen in maintaining NEDA status in all epochs evaluated. By contrast with IFN β-1a, the majority of patients with disease activity early in the study subsequently attained NEDA status with ocrelizumab.
使用固定的研究入组基线,无疾病活动证据(NEDA;定义为12周内无确诊的残疾进展、无方案定义的复发、无新的/增大的T2病变以及无T1钆增强病变)通常被用作多发性硬化症(MS)的治疗结局。
本文的目的是使用重新基线分析评估奥瑞珠单抗对NEDA的影响以及NEDA状态的预测价值。
在汇总的OPERA I和OPERA II研究中,对接受奥瑞珠单抗(600 mg)或干扰素β-1a(IFN β-1a;44 μg)治疗的复发型MS患者在不同时期的改良意向性治疗人群(n = 1520)中评估NEDA。
与IFN β-1a相比,奥瑞珠单抗在96周时使NEDA增加了75%(P < 0.001),在第0至24周增加了33%(P < 0.001),在第24至96周增加了72%(P < 0.001)。在第0至24周有疾病活动的患者中,奥瑞珠单抗组和IFN β-1a组在第24至96周达到NEDA的比例分别为66.4%和24.3%(相对增加:177%;P < 0.001)。
在所有评估时期,与IFN β-1a相比,奥瑞珠单抗在维持NEDA状态方面始终显示出更高的疗效。与IFN β-1a相反,在研究早期有疾病活动的大多数患者随后使用奥瑞珠单抗达到了NEDA状态。