按年龄划分的多发性硬化症患者疾病修饰治疗处方模式。
Disease-modifying therapy prescription patterns in people with multiple sclerosis by age.
作者信息
Zhang Yinan, Salter Amber, Jin Shan, Culpepper William J, Cutter Gary R, Wallin Mitchell, Stuve Olaf
机构信息
Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, USA.
出版信息
Ther Adv Neurol Disord. 2021 Mar 31;14:17562864211006499. doi: 10.1177/17562864211006499. eCollection 2021.
BACKGROUND
Disease-modifying therapies (DMTs) for multiple sclerosis (MS) are approved for their ability to reduce disease activity, namely clinical relapses and signal changes on magnetic resonance imaging (MRI). Disease activity appears age dependent. Thus, the greatest benefit would be expected in younger people with MS (PwMS) whereas benefits in the elderly are uncertain.
METHODS
Real-world data were obtained from PwMS from the North American Research Committee on Multiple Sclerosis (NARCOMS) registry and the US Department of Veterans Affairs Multiple Sclerosis Surveillance Registry (MSSR).
RESULTS
6948 PwMS were surveyed from NARCOMS, and the MSSR had 1719 participants. In younger adult PwMS 40-years old or less, 183 (61.4%) in NARCOMS and 179 (70.5%) in the MSSR were prescribed DMTs. Among PwMS over age 60, 1575 (40.1%) in NARCOMS and 239 (36.3%) in the MSSR were prescribed DMTs. More PwMS in the age group of 31-40 ( = 0.035) and 41-50 ( = 0.001) in the MSSR were using DMTs compared with PwMS of the same age groups in NARCOMS.
CONCLUSION
These findings suggest that DMTs are under-utilized in the younger population and continue to be commonly prescribed in the elderly. Broader access may explain the higher prescription rate of DMTs in US veterans.
背景
用于治疗多发性硬化症（MS）的疾病修正疗法（DMTs）因其降低疾病活动度的能力而被批准使用，疾病活动度具体表现为临床复发和磁共振成像（MRI）上的信号变化。疾病活动度似乎与年龄有关。因此，预计年轻的多发性硬化症患者（PwMS）能从中获得最大益处，而老年人的获益尚不确定。
方法
实际数据来自北美多发性硬化症研究委员会（NARCOMS）登记处的PwMS以及美国退伍军人事务部多发性硬化症监测登记处（MSSR）。
结果
对NARCOMS登记处的6948名PwMS进行了调查，MSSR有1719名参与者。在40岁及以下的年轻成年PwMS中，NARCOMS登记处有183名（61.4%）、MSSR有179名（70.5%）使用了DMTs。在60岁以上的PwMS中，NARCOMS登记处有1575名（40.1%）、MSSR有239名（36.3%）使用了DMTs。与NARCOMS登记处同年龄组的PwMS相比，MSSR中31 - 40岁（= 0.035）和41 - 50岁（= 0.001）年龄组使用DMTs的PwMS更多。
结论
这些发现表明，DMTs在年轻人群中未得到充分利用，而在老年人中仍被普遍使用。更广泛的获取途径可能解释了美国退伍军人中DMTs较高的处方率。
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