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采用阿替洛尔毒素 A 水剂(Dysport)治疗后,颈肌张力障碍患者生活质量得到改善。

Quality of life improvements in patients with cervical dystonia following treatment with a liquid formulation of abobotulinumtoxinA (Dysport ).

机构信息

Centre Hospitalier Universitaire de Toulouse Pôle Neurosciences Purpan, ToNIC, Université de Toulouse, Inserm, UPS, Toulouse, France.

Ipsen Innovation, Les Ulis, France.

出版信息

Eur J Neurol. 2019 Jun;26(6):943-e65. doi: 10.1111/ene.13800. Epub 2018 Sep 30.

Abstract

BACKGROUND AND PURPOSE

In patients with cervical dystonia, abobotulinumtoxinA solution for injection (ASI) has been shown to be similarly effective to freeze-dried abobotulinumtoxinA in reducing Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) total scores. In this secondary analysis, quality of life data as evaluated with the Cervical Dystonia Impact Profile (CDIP-58) are presented.

METHODS

This was a double-blind, randomized, active and placebo-controlled study followed by an open-label extension (NCT01261611). In the double-blind phase, patients were randomized (3:3:1) to one cycle of ASI 500 U (n = 156), abobotulinumtoxinA 500 U (n = 159) or placebo (n = 54). Following the double-blind phase, all patients received open-label ASI for up to four cycles.

RESULTS

The CDIP-58 total scores were significantly improved at week 4 of the double-blind phase in both the ASI 500 U and abobotulinumtoxinA 500 U groups versus placebo [least squares mean change from baseline of -9.5 (-11.51, -7.45) and -11.2 (-13.2, -9.26) vs. -0.9 (-4.04, 2.14), respectively; both P < 0.0001 vs. placebo]. All CDIP-58 domains contributed to this improvement and benefits were maintained across open-label treatment. Positive correlations were observed between CDIP-58 total score and all three TWSTRS domains (R = 0.42-0.62) and for all CDIP-58 subscales with the TWSTRS total score and domains (R = 0.23-0.60).

CONCLUSIONS

Repeat ASI injections are similarly effective to abobotulinumtoxinA in improving patient-reported outcomes of health-related quality of life. Positive correlations were found between TWSTRS total and domain scores and CDIP-58 total and domain scores.

摘要

背景与目的

在痉挛性斜颈患者中,已证实注射用阿博特菌素 A 溶液(ASI)在降低多伦多西部痉挛性斜颈评定量表(TWSTRS)总分方面与冻干阿博特菌素 A 同样有效。在这项二次分析中,我们报告了使用颈肌张力障碍影响量表(CDIP-58)评估的生活质量数据。

方法

这是一项双盲、随机、阳性对照和安慰剂对照研究,随后进行了开放性扩展(NCT01261611)。在双盲阶段,患者按 3:3:1 的比例随机分配至 ASI 500 U(n=156)、阿博特菌素 A 500 U(n=159)或安慰剂(n=54)组。在双盲阶段之后,所有患者接受最多四个周期的开放性 ASI 治疗。

结果

在双盲阶段的第 4 周,ASI 500 U 和阿博特菌素 A 500 U 组的 CDIP-58 总分均明显优于安慰剂组[从基线的最小二乘均数变化分别为-9.5(-11.51,-7.45)和-11.2(-13.2,-9.26)与-0.9(-4.04,2.14);与安慰剂相比,均 P<0.0001]。所有 CDIP-58 域都有助于这种改善,并且在开放性治疗中都保持了获益。CDIP-58 总分与所有三个 TWSTRS 域(R=0.42-0.62)以及与 TWSTRS 总分和所有域(R=0.23-0.60)均呈正相关。

结论

重复 ASI 注射与阿博特菌素 A 同样有效,可改善患者报告的健康相关生活质量结局。在 TWSTRS 总分和各域评分与 CDIP-58 总分和各域评分之间发现了正相关。

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