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Octagam®治疗慢性炎症性脱髓鞘性多发性神经病患者的疗效与安全性

Efficacy and Safety of Octagam® in Patients With Chronic Inflammatory Demyelinating Polyneuropathy.

作者信息

Belmokhtar Chafké, Lozeron Pierre, Adams David, Franques Jérôme, Lacour Arnaud, Godet Etienne, Bataille Mathieu, Dubourg Odile, Angibaud Gilles, Delmont Emilien, Bouhour Françoise, Corcia Philippe, Pouget Jean

机构信息

Octapharma SAS, 62 bis Avenue André Morizet, Boulogne-Billancourt, 92100, Paris, France.

Lariboisiere University Hospital, 2 Rue Ambroise Paré, 75010, Paris, France.

出版信息

Neurol Ther. 2019 Jun;8(1):69-78. doi: 10.1007/s40120-019-0132-5. Epub 2019 Mar 22.

Abstract

INTRODUCTION

Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is a debilitating autoimmune neuropathy that is treated with intravenous immunoglobulin (IVIG). The aim of this retrospective study was to investigate the efficacy and safety of the sucrose-free IVIG Octagam® (Octapharma AG, Lachen, Switzerland) in patients with CIDP.

METHODS

Data from 47 patients who received at least one dose of Octagam were collected from the records of 11 centres in France. Efficacy was assessed using Overall Neuropathy Limitation Scale (ONLS). Safety was evaluated using adverse event rates.

RESULTS

Data from 24 patients who were IVIG naïve (n = 11) or had stopped IVIG ≥ 12 weeks before   initiation of Octagam therapy (washout group; n  = 13) were included in the efficacy analysis. At 4 months post-initiation of Octagam treatment, 41.7% of patients had improved their functional status (decrease of ≥ 1 ONLS score) with a significant change   in the ONLS score from baseline (- 0.42; p = 0.04; signed test). Functional status was reduced in only two patients: one patient in the IVIG-naïve group and one patient in the IVIG-washout group. All 47 patients were included in the safety analysis, which showed that Octagam was well tolerated, with a frequency of 0.04 adverse events per Octagam course. The most common adverse drug reaction was headache.

CONCLUSIONS

These real-life results are consistent with the efficacy and safety of IVIG reported in randomised controlled studies. A long-term prospective study of Octagam in patients with CIDP is warranted.

FUNDING

Octapharma, France SAS.

摘要

引言

慢性炎症性脱髓鞘性多发性神经根神经病(CIDP)是一种使人衰弱的自身免疫性神经病,采用静脉注射免疫球蛋白(IVIG)进行治疗。这项回顾性研究的目的是调查无糖型IVIG Octagam®(奥克太法玛公司,瑞士拉肯)治疗CIDP患者的疗效和安全性。

方法

从法国11个中心的记录中收集了47例接受至少一剂Octagam治疗患者的数据。使用总体神经病变限制量表(ONLS)评估疗效。通过不良事件发生率评估安全性。

结果

疗效分析纳入了24例初次接受IVIG治疗(n = 11)或在开始Octagam治疗前≥12周已停用IVIG的患者(洗脱组;n = 13)。在开始Octagam治疗4个月后,41.7%的患者功能状态得到改善(ONLS评分降低≥1分),ONLS评分与基线相比有显著变化(-0.42;p = 0.04;符号检验)。仅2例患者功能状态下降:1例初次接受IVIG治疗组患者和1例IVIG洗脱组患者。47例患者均纳入安全性分析,结果显示Octagam耐受性良好,每个Octagam疗程的不良事件发生率为0.04。最常见的药物不良反应是头痛。

结论

这些实际结果与随机对照研究中报道的IVIG的疗效和安全性一致。有必要对Octagam治疗CIDP患者进行长期前瞻性研究。

资助

法国奥克太法玛公司。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc5c/6534624/9bd862ef4ea8/40120_2019_132_Fig1_HTML.jpg

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