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单克隆抗体“阿仑单抗”在多发性硬化症治疗中的作用

Role of Monoclonal Antibody "Alemtuzumab" in the Treatment of Multiple Sclerosis.

作者信息

Nosher Sadia, Fuad Sehrish, Mishra Nupur, Alrashid Zaid A, Rathod Bindu, Mohan Devyani, Basavanagowda Deepak M, Kaur Arveen, Heindl Stacey E

机构信息

Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.

Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.

出版信息

Cureus. 2021 Feb 9;13(2):e13246. doi: 10.7759/cureus.13246.

DOI:10.7759/cureus.13246
PMID:33728194
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7948316/
Abstract

This article will review current treatment options for multiple sclerosis (MS) while keeping our primary focus on alemtuzumab, as it is now approved in more than 65 countries. From a pathophysiological point of view, MS is a disabling disease impacting a patient's life both physically and mentally, leading to devastating social and economic impact. This review will elaborate on alemtuzumab's role in treating relapsing-remitting MS (RRMS) by comparing its efficacy, side effects, and monitoring with other disease-modifying therapies (DMTs) available in the market. It is a point of great concern not only for physicians but also for neurologists, nephrologists, endocrinologists, dermatologists, and oncologists when encountering long-term effects of alemtuzumab in the life of treated MS patients. We hope that our review will not only benefit treating faculties but also those who are suffering from this devastating disease.

摘要

本文将回顾目前针对多发性硬化症(MS)的治疗方案,同时我们将主要聚焦于阿仑单抗,因为它目前已在65多个国家获得批准。从病理生理学角度来看,MS是一种致残性疾病,会在身体和心理上影响患者的生活,导致巨大的社会和经济影响。本综述将通过比较阿仑单抗与市场上其他疾病修正疗法(DMTs)的疗效、副作用和监测情况,阐述其在治疗复发缓解型多发性硬化症(RRMS)中的作用。当遇到阿仑单抗对接受治疗的MS患者生活产生的长期影响时,这不仅是医生,也是神经科医生、肾科医生、内分泌科医生、皮肤科医生和肿瘤科医生极为关注的问题。我们希望我们的综述不仅能使治疗人员受益,也能使那些患有这种毁灭性疾病的人受益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/235e/7948316/662f83ba032f/cureus-0013-00000013246-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/235e/7948316/662f83ba032f/cureus-0013-00000013246-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/235e/7948316/662f83ba032f/cureus-0013-00000013246-i01.jpg

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本文引用的文献

1
Intracerebral haemorrhage during alemtuzumab administration.使用阿仑单抗期间发生的脑出血。
Lancet Neurol. 2019 Apr;18(4):329-331. doi: 10.1016/S1474-4422(19)30076-6. Epub 2019 Feb 15.
2
Longitudinal Characterization of Autoantibodies to the Thyrotropin Receptor (TRAb) During Alemtuzumab Therapy: Evidence that TRAb May Precede Thyroid Dysfunction by Many Years.在阿仑单抗治疗期间促甲状腺素受体(TRAb)自身抗体的纵向特征:TRAb 可能在甲状腺功能障碍多年前出现的证据。
Thyroid. 2018 Dec;28(12):1682-1693. doi: 10.1089/thy.2018.0232. Epub 2018 Dec 4.
3
Alemtuzumab-Induced Thyroid Dysfunction Exhibits Distinctive Clinical and Immunological Features.
阿仑单抗诱导的甲状腺功能障碍表现出独特的临床和免疫学特征。
J Clin Endocrinol Metab. 2018 Aug 1;103(8):3010-3018. doi: 10.1210/jc.2018-00359.
4
Neutropenia with fatal outcome in a multiple sclerosis patient 23 days after alemtuzumab infusion.在接受阿仑单抗输注 23 天后,一位多发性硬化症患者出现中性粒细胞减少伴致命结局。
Mult Scler Relat Disord. 2018 Jul;23:15-16. doi: 10.1016/j.msard.2018.04.014. Epub 2018 Apr 28.
5
Hemophagocytic lymphohistiocytosis in 2 patients with multiple sclerosis treated with alemtuzumab.2例接受阿仑单抗治疗的多发性硬化患者发生噬血细胞性淋巴组织细胞增生症。
Neurology. 2018 May 1;90(18):849-851. doi: 10.1212/WNL.0000000000005420. Epub 2018 Mar 30.
6
Visual consequences of medications for multiple sclerosis: the good, the bad, the ugly, and the unknown.治疗多发性硬化症药物的视觉后果:好的、坏的、丑陋的以及未知的。
Eye Brain. 2017 Jun 29;9:13-21. doi: 10.2147/EB.S140481. eCollection 2017.
7
Interpreting Lymphocyte Reconstitution Data From the Pivotal Phase 3 Trials of Alemtuzumab.解读阿仑单抗关键3期试验中的淋巴细胞重建数据。
JAMA Neurol. 2017 Aug 1;74(8):961-969. doi: 10.1001/jamaneurol.2017.0676.
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Disseminated necrotizing leukoencephalopathy eight months after alemtuzumab treatment for multiple sclerosis.阿仑单抗治疗多发性硬化症八个月后发生播散性坏死性白质脑病。
Acta Neuropathol Commun. 2016 Aug 8;4(1):81. doi: 10.1186/s40478-016-0352-1.
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Advances in and Algorithms for the Treatment of Relapsing-Remitting Multiple Sclerosis.复发缓解型多发性硬化症的治疗进展与算法。
Neurotherapeutics. 2016 Jan;13(1):47-57. doi: 10.1007/s13311-015-0412-4.
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