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富马酸二甲酯治疗初治日本多发性硬化症患者的疗效和安全性:随机安慰剂对照研究的中期分析

Efficacy and safety of dimethyl fumarate in treatment-naïve Japanese patients with multiple sclerosis: Interim analysis of the randomized placebo-controlled study.

作者信息

Mori Masahiro, Ohashi Takashi, Onizuka Yasuhiro, Hiramatsu Katsutoshi, Hase Masakazu, Yun Jang, Matta André, Torii Shinichi

机构信息

Department of Neurology, Chiba University, Japan.

Department of Neurology, Tokyo Women's Medical University Yachiyo Medical Center, Japan.

出版信息

Mult Scler J Exp Transl Clin. 2019 Jun 10;5(2):2055217319852727. doi: 10.1177/2055217319852727. eCollection 2019 Apr-Jun.

DOI:10.1177/2055217319852727
PMID:31218077
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6558550/
Abstract

BACKGROUND

The use of dimethyl fumarate has not been reported in treatment-naïve Japanese patients with relapsing-remitting multiple sclerosis.

OBJECTIVES

The purpose of this study was to evaluate the efficacy and safety of dimethyl fumarate in treatment-naïve Japanese patients with relapsing-remitting multiple sclerosis.

METHODS

APEX was a phase 3, multinational trial, which consisted of a 24-week, randomized (1:1), double-blind study where patients received dimethyl fumarate 240 mg or placebo twice daily, followed by an open-label extension where all patients received dimethyl fumarate 240 mg. The primary endpoints were the total number of new gadolinium-enhancing (Gd+) lesions in Weeks 12-24 (Part I) and long-term safety (Part II). This post-hoc subgroup analysis evaluated the efficacy and safety of dimethyl fumarate in treatment-naïve Japanese patients with relapsing-remitting multiple sclerosis (=52) up to Week 72 (24 weeks Part I and 48 weeks Part II).

RESULTS

Dimethyl fumarate reduced the mean total number of new gadolinium-enhancing lesions at Weeks 12-24 by 94% versus placebo; the number of patients who had a relapse over 24 weeks was reduced by 72%. Adverse events leading to discontinuation of the study drug were reported in 9% of patients receiving placebo/dimethyl fumarate and 4% of patients in dimethyl fumarate/dimethyl fumarate.

CONCLUSIONS

Dimethyl fumarate demonstrated sustained efficacy and acceptable tolerability in treatment-naïve Japanese patients with relapsing-remitting multiple sclerosis for 72 weeks.

摘要

背景

在初治复发缓解型多发性硬化症的日本患者中,尚未有使用富马酸二甲酯的报道。

目的

本研究旨在评估富马酸二甲酯在初治复发缓解型多发性硬化症日本患者中的疗效和安全性。

方法

APEX是一项3期多国试验,包括一项为期24周的随机(1:1)双盲研究,患者每日两次接受240mg富马酸二甲酯或安慰剂,随后是开放标签扩展期,所有患者均接受240mg富马酸二甲酯。主要终点为第12 - 24周(第一部分)新钆增强(Gd +)病灶总数和长期安全性(第二部分)。这项事后亚组分析评估了富马酸二甲酯在初治复发缓解型多发性硬化症日本患者(n = 52)中至第72周(第一部分24周和第二部分48周)的疗效和安全性。

结果

与安慰剂相比,富马酸二甲酯在第12 - 24周时将新钆增强病灶的平均总数减少了94%;24周内复发的患者数量减少了72%。接受安慰剂/富马酸二甲酯的患者中有9%报告了导致停用研究药物的不良事件,接受富马酸二甲酯/富马酸二甲酯的患者中有4%报告了此类不良事件。

结论

富马酸二甲酯在初治复发缓解型多发性硬化症日本患者中持续72周显示出疗效和可接受的耐受性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d296/6558550/3db71973f1a4/10.1177_2055217319852727-fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d296/6558550/a9c0ee939cf5/10.1177_2055217319852727-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d296/6558550/5f3756de91aa/10.1177_2055217319852727-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d296/6558550/05c5ec99c005/10.1177_2055217319852727-fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d296/6558550/3db71973f1a4/10.1177_2055217319852727-fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d296/6558550/a9c0ee939cf5/10.1177_2055217319852727-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d296/6558550/5f3756de91aa/10.1177_2055217319852727-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d296/6558550/05c5ec99c005/10.1177_2055217319852727-fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d296/6558550/3db71973f1a4/10.1177_2055217319852727-fig4.jpg

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