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在复发缓解型多发性硬化症中,特立氟胺治疗的获益风险比良好:奥地利为期2年的多中心、前瞻性、非干预性TAURUS MS研究结果

Favorable benefit-risk ratio with teriflunomide treatment in relapsing-remitting multiple sclerosis: Results of the 2-year, multicenter, prospective, noninterventional TAURUS MS study in Austria.

作者信息

Guger Michael, Ackerl Michael Matthias, Heine Martin, Hofinger-Renner Christiane, Spiss Heinrich Karl, Taut Andrea, Unger Karin, Leutmezer Fritz

机构信息

Department of Neurology, Pyhrn-Eisenwurzen Hospital Steyr, Austria.

Medical Faculty, Johannes Kepler University Linz, Linz, Austria.

出版信息

eNeurologicalSci. 2022 Mar 7;27:100396. doi: 10.1016/j.ensci.2022.100396. eCollection 2022 Jun.

Abstract

OBJECTIVES

A prospective, multicenter, open-label, noninterventional study assessed the efficacy, safety, tolerability, and patient satisfaction with teriflunomide therapy over a 24-month follow-up period under real-world conditions in Austria.

METHODS

An all-comer population aged ≥18 years was followed in clinic and office-based settings. The primary objective of the study was the annualized relapse rate after 12 and 24 months of teriflunomide treatment. Patient-reported outcomes included treatment satisfaction, health-related quality of life, and fatigue, and were assessed based on the Short Form Health-36, Fatigue Severity Scale, and Treatment Satisfaction Questionnaire for Medication (TSQM)-9 questionnaires.

RESULTS

Thirty-one patients were included in the analysis, 23 of whom were still on treatment after 24 months. At 12 months ( = 24), the annualized relapse rate was 0.3 (SD, 0.8), which indicated a significant decrease compared to the annualized relapse rate of 1.0 (SD, 0.9) observed during the 12-month reference period prior to treatment initiation ( = 0.009). Similarly, after 24 months of follow-up ( = 23), the annualized relapse rate of 0.2 (SD, 0.8) was significantly lower than that during the last 24 months reference period prior to treatment initiation of 0.7 (SD, 0.8) ( = 0.0003). The Expanded Disability Status Scale score remained stable over 12 and 24 months. This also applied to patient-reported fatigue of the Fatigue Severity Scale, with a mean change of 0.1 (SD, 1.0). Patient treatment satisfaction as assessed by the TSQM-9 increased for all three domains (i.e., effectiveness, convenience, global satisfaction). This was confirmed by the physician and multiple sclerosis nurse ratings of patient treatment satisfaction and ease of use. Adverse events occurred in 38.7%, with hair thinning and diarrhea as the most common.

CONCLUSIONS

This noninterventional study showed a sustained favorable benefit-risk ratio for this disease-modifying treatment with teriflunomide over 24 months in patients with relapsing-remitting multiple sclerosis. Patient-reported outcomes and ratings performed by physicians and nurses showed overall trends to improvement for patient treatment satisfaction with teriflunomide treatment and its ease of administration.

摘要

目的

一项前瞻性、多中心、开放标签、非干预性研究,在奥地利的实际临床环境中,对特立氟胺治疗24个月的疗效、安全性、耐受性及患者满意度进行评估。

方法

≥18岁的所有患者在门诊和办公室环境中接受随访。本研究的主要目的是评估特立氟胺治疗12个月和24个月后的年化复发率。患者报告的结局包括治疗满意度、健康相关生活质量和疲劳程度,通过简明健康状况调查量表、疲劳严重程度量表及药物治疗满意度问卷(TSQM)-9进行评估。

结果

31例患者纳入分析,其中23例在24个月后仍在接受治疗。在12个月时(n = 24),年化复发率为0.3(标准差,0.8),与治疗开始前12个月参考期内观察到的年化复发率1.0(标准差,0.9)相比显著降低(P = 0.009)。同样,随访24个月后(n = 23),年化复发率0.2(标准差,0.8)显著低于治疗开始前最后24个月参考期内的0.7(标准差,0.8)(P = 0.0003)。扩展残疾状态量表评分在12个月和24个月期间保持稳定。疲劳严重程度量表中患者报告的疲劳情况也是如此,平均变化为0.1(标准差,1.0)。TSQM-9评估的患者治疗满意度在所有三个领域(即有效性、便利性、总体满意度)均有所提高。医生和多发性硬化症护士对患者治疗满意度和易用性的评分也证实了这一点。38.7%的患者发生不良事件,最常见的是头发稀疏和腹泻。

结论

这项非干预性研究表明,对于复发缓解型多发性硬化症患者,特立氟胺这种疾病修饰治疗在24个月内持续呈现良好的效益风险比。患者报告的结局以及医生和护士的评分显示,患者对特立氟胺治疗及其给药便利性的总体满意度呈改善趋势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3eb8/8919225/bb0aad945b09/gr1.jpg

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