Kapica-Topczewska Katarzyna, Collin François, Tarasiuk Joanna, Czarnowska Agata, Chorąży Monika, Mirończuk Anna, Kochanowicz Jan, Kułakowska Alina
Department of Neurology, Medical University of Bialystok, 15-276 Bialystok, Poland.
Independent Statistical Consultant, 40-668 Katowice, Poland.
J Clin Med. 2021 Feb 19;10(4):868. doi: 10.3390/jcm10040868.
The aim of the study was to verify the association of clinical relapses and brain activity with disability progression in relapsing/remitting multiple sclerosis patients receiving disease-modifying treatments in Poland. Disability progression was defined as relapse-associated worsening (RAW), progression independent of relapse activity (PIRA), and progression independent of relapses and brain MRI Activity (PIRMA). Data from the Therapeutic Program Monitoring System were analyzed. Three panels of patients were identified: R0, no relapse during treatment, and R1 and R2 with the occurrence of relapse during the first and the second year of treatment, respectively. In the R0 panel, we detected 4.6% PIRA patients at 24 months ( < 0.001, 5.0% at 36 months, 5.6% at 48 months, 6.1% at 60 months). When restricting this panel to patients without brain MRI activity, we detected 3.0% PIRMA patients at 12 months, 4.5% at 24 months, and varying from 5.3% to 6.2% between 36 and 60 months of treatment, respectively. In the R1 panel, RAW was detected in 15.6% patients at 12 months and, in the absence of further relapses, 9.7% at 24 months and 6.8% at 36 months of treatment. The R2 group was associated with RAW significantly more frequently at 24 months compared to the R1 at 12 months (20.7%; < 0.05), but without a statistical difference later on. In our work, we confirmed that disability progression was independent of relapses and brain MRI activity.
该研究的目的是验证在波兰接受疾病修正治疗的复发/缓解型多发性硬化症患者中，临床复发和脑活动与残疾进展之间的关联。残疾进展被定义为与复发相关的恶化（RAW）、与复发活动无关的进展（PIRA）以及与复发和脑MRI活动无关的进展（PIRMA）。对治疗项目监测系统的数据进行了分析。确定了三组患者：R0组，治疗期间无复发；R1组和R2组，分别在治疗的第一年和第二年出现复发。在R0组中，我们在24个月时检测到4.6%的PIRA患者（<0.001），36个月时为5.0%，48个月时为5.6%，60个月时为6.1%。当将该组限制为无脑MRI活动的患者时，我们在12个月时检测到3.0%的PIRMA患者，24个月时为4.5%，在治疗36至60个月期间分别为5.3%至6.2%。在R1组中，12个月时在15.6%的患者中检测到RAW，在没有进一步复发的情况下，24个月时为9.7%，36个月时为6.8%。与12个月时的R1组相比，R2组在24个月时与RAW的关联明显更频繁（20.7%；<0.05），但后来没有统计学差异。在我们的研究中，我们证实了残疾进展与复发和脑MRI活动无关。
