Patrucco Liliana, Cristiano Edgardo, Sánchez Francisco, Miguez Jimena, Rojas Juan Ignacio
Centro de Esclerosis Múltiple de Buenos Aires.
Sección Enfermedades Desmielinizantes, Servicio de Neurología, Hospital Italiano de Buenos Aires, Argentina.
Clin Neuropharmacol. 2019 Sep/Oct;42(5):163-166. doi: 10.1097/WNF.0000000000000358.
The aim of this prospective observational postmarketing study was to evaluate fingolimod effectiveness in a real-world setting in Buenos Aires, Argentina.
Relapsing remitting multiple sclerosis patients who had been prescribed fingolimod owing to treatment failure and had at least greater than or equal to 24 months of follow-up were included during August 2013 and June 2018. Three-monthly clinical evaluations and 12-monthly magnetic resonance were performed. Demographic and clinical variables were described as well as the safety and the effectiveness outcomes that included the proportion of patients free from clinical relapses, from disability progression, from new or enlarging T2 or T1 gadolinium-enhancing lesions on annual magnetic resonance imaging, and from any disease activity during the follow-up.
A total of 97 patients were included (68% female [n = 66]; mean ± SD age, 30 ± 10.5 years; mean ± SD disease duration, 6.5 ± 3.1 years; mean ± SD Expanded Disability Status Scale, 3.5 ± 1; mean ± SD fingolimod use, 30 ± 13 months [range, 18-56 months]). One hundred percent (97) used previous disease-modifying therapy, mainly interferons (87%; n = 84). Fourteen patients (14.4%) discontinued/withdrew fingolimod (10 owing to disease activity and 4 owing to tolerance and personal decisions). Eighty-two percent were free from clinical relapses, and 85% were free from disability progression; 75% of patients remained free from new or newly enlarging T2 lesions, and 78% of patients were free from gadolinium enhancing lesions. The proportion of patients free from any disease activity was 54%.
The effectiveness of fingolimod in a newly real-world setting was consistent with information provided from phase III clinical trials.
这项前瞻性观察性上市后研究的目的是评估芬戈莫德在阿根廷布宜诺斯艾利斯的实际应用中的有效性。
纳入2013年8月至2018年6月期间因治疗失败而被处方使用芬戈莫德且至少有大于或等于24个月随访期的复发缓解型多发性硬化症患者。每三个月进行一次临床评估,每年进行一次磁共振成像检查。描述了人口统计学和临床变量以及安全性和有效性结果,包括无临床复发、无残疾进展、在年度磁共振成像上无新的或扩大的T2或T1钆增强病灶以及随访期间无任何疾病活动的患者比例。
共纳入97例患者(68%为女性[n = 66];平均±标准差年龄,30±10.5岁;平均±标准差病程,6.5±3.1年;平均±标准差扩展残疾状态量表,3.5±1;平均±标准差芬戈莫德使用时间,30±13个月[范围,18 - 56个月])。100%(97例)患者曾使用过疾病修饰治疗,主要是干扰素(87%;n = 84)。14例患者(14.4%)停用/退出芬戈莫德治疗(10例因疾病活动,4例因耐受性和个人决定)。82%的患者无临床复发,85%的患者无残疾进展;75%的患者无新的或新扩大的T2病灶,78%的患者无钆增强病灶。无任何疾病活动的患者比例为54%。
芬戈莫德在新的实际应用环境中的有效性与III期临床试验提供的信息一致。