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葡萄牙多发性硬化症患者体内的JC病毒抗体:JUSTIFY研究结果

JC virus antibodies in Portuguese multiple sclerosis patients: JUSTIFY study results.

作者信息

Sá Maria José, Nunes Carla Cecília, da Silva Ana Martins, Mota Patrícia, Pinto-Marques José

机构信息

Centro Hospitalar de São João, Hospital de São João, Department of Neurology, Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, Porto, Portugal.

Centro Hospitalar e Universitário de Coimbra, Hospitais da Universidade de Coimbra, Department of Neurology, Coimbra, Portugal.

出版信息

J Neurol Sci. 2019 Nov 15;406:116426. doi: 10.1016/j.jns.2019.116426. Epub 2019 Aug 13.

Abstract

OBJECTIVE

To confirm anti-JC virus (JCV) antibody seroprevalence in Portuguese patients with relapsing-remitting multiple sclerosis (RRMS) and to determine their anti-JCV antibody index.

METHODS

JUSTIFY was a retrospective, multicentre study that included 655 RRMS patients tested at least once with the anti-JCV antibody assay STRATIFY JCV DxSelect. Demographic data, multiple sclerosis history and results of the anti-JCV antibody test were collected, along with physicians' reasons for requesting the test and the impact of the results.

RESULTS

Overall anti-JCV antibody seroprevalence was 60.8% (95% confidence interval, 56.9-64.5). Seroprevalence was associated with higher age (P = .030) and was lower in natalizumab-treated patients (P < .001). The mean anti-JCV antibody index of immunosuppressant-naive patients was 1.5 ± 1.3 (n = 378). The main reasons for performing the test were clinical characterization (35.5%) and medication change (26.2%). In patients who switched treatments (n = 109), fingolimod (47.7%) and natalizumab (26.6%) were the most commonly chosen new treatments.

CONCLUSIONS

The study confirmed the high anti-JCV antibody prevalence in Portuguese RRMS patients and its association with age. These data can be used to better understand the benefit-risk profile of natalizumab treatment in Portuguese patients and to support progressive multifocal leukoencephalopathy risk management strategies.

摘要

目的

确认葡萄牙复发缓解型多发性硬化症(RRMS)患者的抗JC病毒(JCV)抗体血清阳性率,并确定其抗JCV抗体指数。

方法

JUSTIFY是一项回顾性多中心研究,纳入了655例RRMS患者,这些患者至少接受过一次抗JCV抗体检测STRATIFY JCV DxSelect。收集了人口统计学数据、多发性硬化症病史、抗JCV抗体检测结果,以及医生要求进行检测的原因和检测结果的影响。

结果

总体抗JCV抗体血清阳性率为60.8%(95%置信区间,56.9 - 64.5)。血清阳性率与年龄较大相关(P = 0.030),在接受那他珠单抗治疗的患者中较低(P < 0.001)。未使用免疫抑制剂患者的平均抗JCV抗体指数为1.5±1.3(n = 378)。进行检测的主要原因是临床特征分析(35.5%)和药物变更(26.2%)。在更换治疗方案的患者(n = 109)中,芬戈莫德(47.7%)和那他珠单抗(26.6%)是最常选用的新治疗药物。

结论

该研究证实了葡萄牙RRMS患者中抗JCV抗体的高流行率及其与年龄的相关性。这些数据可用于更好地了解那他珠单抗治疗对葡萄牙患者的获益风险情况,并支持进行性多灶性白质脑病风险管理策略。

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