South Shore Neurologic Associates, Patchogue, NY, USA.
Washington Neuropsychology Research Group LLC, Fairfax, VA, USA.
CNS Drugs. 2018 Dec;32(12):1173-1181. doi: 10.1007/s40263-018-0553-1.
Cognitive impairment affects many patients with multiple sclerosis (MS). NeuroTrax, a computerized cognitive screen that can be administered during routine clinical care, provides a consistent, validated, objective cognitive profile measure with a global cognitive score (GCS) and seven individual domain scores. Natalizumab is an efficacious therapy for relapsing MS, demonstrating reductions in disability worsening and MS disease activity measured by magnetic resonance imaging.
The aim of this study was to assess cognitive function as measured by NeuroTrax in MS patients treated with natalizumab for ≥ 2 years.
This retrospective observational study included adult MS patients in the United States who received 300 mg intravenous natalizumab every 4 weeks for ≥ 2 years. NeuroTrax data were evaluated at baseline and yearly thereafter. Changes in GCS and the seven individual cognitive domain scores from baseline to after 24 infusions of natalizumab were analyzed.
In the study population at baseline (N = 52), 22 patients (42.3%) had disease duration of 0-5 years; 12 patients (23.1%) were treatment naive. GCS score improved significantly from baseline [mean 95.5, standard deviation (SD) 12.9] to year 2 (mean 98.9, SD 13.2; change from baseline 3.4; p = 0.003). After 2 years on natalizumab, 17 patients (32.7%) demonstrated clinically significant improvement (increase from baseline > 1 SD) in GCS. Results were similar regardless of whether patients had previously received MS therapy.
Patients treated with natalizumab demonstrated significant improvement in cognitive function, measured by NeuroTrax GCS, over 2 years of treatment.
认知障碍影响许多多发性硬化症（MS）患者。NeuroTrax 是一种计算机化的认知筛查工具，可以在常规临床护理中进行，提供一致、经过验证的客观认知档案测量，包括一个总体认知评分（GCS）和七个个体领域评分。那他利珠单抗是一种有效的治疗复发性 MS 的药物，通过磁共振成像测量显示可减少残疾恶化和 MS 疾病活动。
本研究旨在评估接受那他利珠单抗治疗≥2 年的 MS 患者的神经认知功能。
这是一项在美国进行的回顾性观察性研究，纳入接受每 4 周静脉注射 300mg 那他利珠单抗治疗≥2 年的成年 MS 患者。在基线和此后每年评估 NeuroTrax 数据。从基线到接受 24 次那他利珠单抗治疗后的 GCS 和七个个体认知域评分的变化进行分析。
在研究人群的基线（N=52）中，22 例（42.3%）患者疾病持续时间为 0-5 年；12 例（23.1%）患者为初治。GCS 评分从基线（平均 95.5，SD 12.9）显著改善至第 2 年（平均 98.9，SD 13.2；与基线相比的变化为 3.4；p=0.003）。在接受那他利珠单抗治疗 2 年后，17 例（32.7%）患者的 GCS 表现出临床显著改善（与基线相比增加>1 SD）。无论患者是否之前接受过 MS 治疗，结果都相似。
接受那他利珠单抗治疗的患者在 2 年的治疗中，神经认知功能（通过 NeuroTrax GCS 测量）显著改善。
