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干扰素治疗多发性硬化症:临床疗效、安全性及耐受性最新进展

Interferons in the Treatment of Multiple Sclerosis: A Clinical Efficacy, Safety, and Tolerability Update.

作者信息

Filipi Mary, Jack Samantha

出版信息

Int J MS Care. 2020 Jul-Aug;22(4):165-172. doi: 10.7224/1537-2073.2018-063. Epub 2019 Oct 30.

Abstract

Interferon beta (IFNβ) was the first disease-modifying therapy available to treat multiple sclerosis (MS), providing patients with a treatment that resulted in reduced relapse rates and delays in the onset of disability. Four IFNβ drugs are currently approved to treat relapsing forms of MS: subcutaneous (SC) IFNβ-1b, SC IFNβ-1a, intramuscular IFNβ-1a, and, most recently, SC peginterferon beta-1a. Peginterferon beta-1a has an extended half-life and requires less frequent administration than other available treatments (once every 2 weeks vs every other day, 3 times per week, or weekly). Large randomized controlled clinical trials have confirmed the efficacy of interferons for the treatment of relapsing MS. The most frequent adverse events in patients receiving IFNs include injection site reactions and flu-like symptoms. Patient education and mitigation strategies are key to managing these adverse events and supporting therapy adherence. With fewer injections needed, peginterferon beta-1a is associated with less frequent discomfort, which may translate to improved adherence, a major factor in treatment efficacy. Because the available interferon therapies differ in administration route and frequency of injection, switching among these therapies may be a viable option for patients who experience issues with tolerability. Although a variety of disease-modifying therapies are now available to treat relapsing MS, the efficacy and long-term safety profile of interferons make them an important first-line option for treatment.

摘要

干扰素β(IFNβ)是首个可用于治疗多发性硬化症(MS)的疾病修正疗法,为患者提供了一种能降低复发率并延缓残疾发生的治疗方法。目前有四种IFNβ药物被批准用于治疗复发型MS:皮下注射(SC)IFNβ-1b、SC IFNβ-1a、肌肉注射IFNβ-1a,以及最近的SC聚乙二醇化干扰素β-1a。聚乙二醇化干扰素β-1a半衰期延长,给药频率低于其他现有治疗方法(每2周一次,而不是隔天一次、每周3次或每周一次)。大型随机对照临床试验已证实干扰素治疗复发型MS的疗效。接受IFN治疗的患者中最常见的不良事件包括注射部位反应和流感样症状。患者教育和缓解策略是管理这些不良事件及支持治疗依从性的关键。由于聚乙二醇化干扰素β-1a所需注射次数较少,其不适频率较低,这可能转化为依从性提高,而依从性是治疗疗效的一个主要因素。由于现有的干扰素疗法在给药途径和注射频率上有所不同,对于耐受性出现问题的患者,在这些疗法之间切换可能是一个可行的选择。尽管现在有多种疾病修正疗法可用于治疗复发型MS,但干扰素的疗效和长期安全性使其成为重要的一线治疗选择。

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