Institute for Neurological Research Dr Raul Carrea, FLENI, Neurology Department, Buenos Aires, Argentina.
Hospital Aleman, Department of Neuroscience, Neuroimmunology Unit, Buenos Aires, Argentina.
Arq Neuropsiquiatr. 2021 May;79(5):407-414. doi: 10.1590/0004-282X-ANP-2020-0303.
The real-world effectiveness of natalizumab in people with relapsing multiple sclerosis (PwRMS) in Argentina and Chile has not been reported.
To evaluate the effectiveness of natalizumab treatment in PwRMS in Argentina and Chile, in clinical practice.
We conducted a multicenter retrospective and observational study. We reviewed the medical records of PwRMS who had been treated with natalizumab for at least one year, without any interruption in MS treatment that lasted more than 12 weeks. We analyzed changes in annualized relapse rate (ARR), Expanded Disability Status Scale (EDSS) score and magnetic resonance imaging (MRI).
We enrolled 117 PwRMS treated with natalizumab. Natalizumab treatment was associated with a significant reduction in ARR from baseline after one year and two years of treatment (from 1.97 to 0.06 and 0.09 respectively; p<0.01 at each time point). From baseline, EDSS scores were reduced by 0.71 and 0.73 points at one and two years, respectively (p<0.01). No worsening of disability was observed in 82.9 and 67.5% of PwRMS at one and two years, respectively. The improvement in disability was 44.4% at one year and 39.3% at two years. During natalizumab treatment, the number of relapse-related hospitalizations was significantly reduced (p<0.01). MRI lesions (new/enlarging T2 or gadolinium-enhancing) were significantly reduced, compared with baseline. No evidence of disease activity was observed in 65% at two years of natalizumab treatment.
Natalizumab significantly reduced disease activity in PwRMS in Argentina and Chile, in clinical practice. Natalizumab also decreased the number of hospitalizations compared with pre-natalizumab treatment.
在阿根廷和智利,尚无关于那他珠单抗治疗复发型多发性硬化症(RMS)患者的真实世界疗效的报道。
评估那他珠单抗治疗阿根廷和智利临床实践中RMS 患者的疗效。
我们进行了一项多中心回顾性观察性研究。我们对至少接受了 1 年那他珠单抗治疗且无任何持续超过 12 周的 MS 治疗中断的 RMS 患者的病历进行了回顾性分析。我们分析了年复发率(ARR)、扩展残疾状况量表(EDSS)评分和磁共振成像(MRI)的变化。
我们纳入了 117 例接受那他珠单抗治疗的 RMS 患者。与基线相比,那他珠单抗治疗 1 年和 2 年后的 ARR 显著降低(分别从 1.97 降至 0.06 和 0.09;在每个时间点均 p<0.01)。与基线相比,EDSS 评分在 1 年和 2 年时分别降低了 0.71 和 0.73 分(均 p<0.01)。1 年和 2 年后分别有 82.9%和 67.5%的患者无残疾恶化。1 年时残疾改善的比例为 44.4%,2 年时为 39.3%。在那他珠单抗治疗期间,与治疗前相比,与复发相关的住院次数显著减少(p<0.01)。与基线相比,MRI 病变(新出现/扩大的 T2 或钆增强病灶)显著减少。在那他珠单抗治疗 2 年后,有 65%的患者未观察到疾病活动。
在阿根廷和智利,那他珠单抗在临床实践中显著降低了 RMS 患者的疾病活动度。与治疗前相比,那他珠单抗还减少了住院次数。