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奥瑞珠单抗治疗复发型多发性硬化症 6.5 年后需要助行器的风险:来自 OPERA I 和 OPERA II 试验的数据。

Risk of requiring a walking aid after 6.5 years of ocrelizumab treatment in patients with relapsing multiple sclerosis: Data from the OPERA I and OPERA II trials.

机构信息

Queen Mary University of London, London, UK.

Research Center for Clinical Neuroimmunology and Neuroscience and MS Center, University Hospital Basel and University of Basel, Basel, Switzerland.

出版信息

Eur J Neurol. 2022 Apr;29(4):1238-1242. doi: 10.1111/ene.14823. Epub 2021 May 5.

Abstract

BACKGROUND AND PURPOSE

Requiring a walking aid is a fundamental milestone in multiple sclerosis (MS), represented by an Expanded Disability Status Scale (EDSS) score ≥6.0. In the present study, we assess the effect of ocrelizumab (OCR) on time to EDSS score ≥6.0 in relapsing MS.

METHODS

Time to EDSS score ≥6.0 confirmed for ≥24 and ≥48 weeks was assessed over the course of 6.5 years (336 weeks) in the double-blind period (DBP) and open-label extension (OLE) period of the OPERA I (NCT01247324) and OPERA II (NCT01412333) studies.

RESULTS

Time to reach EDSS score ≥6.0 was significantly delayed in those initially randomized to OCR versus interferon. Over 6.5 years, the risk of requiring a walking aid confirmed for ≥24 weeks was 34% lower among those who initiated OCR earlier versus delayed treatment (average hazard ratio [HR] DBP + OLE 0.66, 95% confidence interval [CI] 0.45-0.95; p = 0.024); the risk of requiring a walking aid confirmed for ≥48 weeks was 46% lower (average HR DBP+OLE 0.54, 95% CI 0.35-0.83; p = 0.004).

CONCLUSION

The reduced risk of requiring a walking aid in earlier initiators of OCR demonstrates the long-term implications of earlier highly effective treatment.

摘要

背景与目的

需要使用助行器是多发性硬化症(MS)的一个重要里程碑,表现为扩展残疾状况量表(EDSS)评分≥6.0。在本研究中,我们评估奥瑞珠单抗(OCR)对复发型 MS 患者达到 EDSS 评分≥6.0 的时间的影响。

方法

在 OPERA I(NCT01247324)和 OPERA II(NCT01412333)研究的双盲期(DBP)和开放标签扩展期(OLE)中,评估 6.5 年内(336 周) EDSS 评分≥6.0 经≥24 和≥48 周确认的时间。

结果

与干扰素相比,最初随机分配到 OCR 的患者达到 EDSS 评分≥6.0 的时间明显延迟。在 6.5 年内,与延迟治疗相比,更早开始 OCR 治疗的患者需要助行器的风险降低了 34%(DBP+OLE 平均危险比 [HR] 0.66,95%置信区间 [CI] 0.45-0.95;p=0.024);需要助行器的风险降低了 46%(DBP+OLE 平均 HR 0.54,95%CI 0.35-0.83;p=0.004)。

结论

OCR 更早开始治疗的患者需要助行器的风险降低,表明早期高效治疗具有长期影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1908/9290576/90899ae37016/ENE-29-1238-g001.jpg

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