Multiple Sclerosis Center, Binaghi Hospital, ATS Sardegna, Dpt of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
Multiple Sclerosis Center, Binaghi Hospital, ATS Sardegna, Dpt of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
J Neurol Sci. 2022 Jul 15;438:120292. doi: 10.1016/j.jns.2022.120292. Epub 2022 May 18.
The present study aims to describe the evolution of teriflunomide use for multiple sclerosis (MS) in the clinical setting, in particular for naïve patients and young women. Predictors of treatment response were also investigated.
This was an independent, retrospective, real-world monocentric study. We analysed the use of teriflunomide from 2016 to 2020 in patients categorized as naïve or switchers, and assessed the variations in its use in men and women by age group. Clinical and MRI data of treated patients were evaluated, and NEDA-3 status at 24 and 36 months was defined. Determinants of therapeutic response were examined using regression analysis.
The study included 319 MS patients exposed to teriflunomide [209 women (65.5%)]. Of these, 67 (21%) were naïve and 252 (79%) were switchers. A 20% increase of teriflunomide use in the naïve group in the past two years, particularly in 2020, the first year of global Sars-Cov-2 spread, was observed. An increase of teriflunomide use of more than 10% in young women under age 45 was also reported. NEDA-3 status was calculated for 204 patients after 24 months and was achieved in 120 (58.8%) of these ones. NEDA-3 was also achieved in 92/160 (56.8%) patients at 36 months. A lower ARR in the two years prior to teriflunomide treatment (p = 0.026), lower baseline age (p = 0.05), and lower EDSS score (p = 0.009) were associated with achievement of the NEDA-3.
Our study confirms a major evolution in teriflunomide use in clinical settings, particularly for naïve patients and young women.
本研究旨在描述在临床环境中,替比夫定在多发性硬化症(MS)中的应用演变,特别是对于初治患者和年轻女性。还研究了治疗反应的预测因素。
这是一项独立的、回顾性的、单中心研究。我们分析了 2016 年至 2020 年期间接受替比夫定治疗的患者的使用情况,根据年龄组评估了男性和女性中替比夫定使用的变化。评估了接受治疗的患者的临床和 MRI 数据,并定义了 24 个月和 36 个月时的 NEDA-3 状态。使用回归分析检查治疗反应的决定因素。
研究共纳入 319 名接受替比夫定治疗的 MS 患者[209 名女性(65.5%)]。其中,67 名(21%)为初治患者,252 名(79%)为转换患者。在过去两年中,初治组替比夫定的使用率增加了 20%,特别是在 2020 年,即全球 Sars-Cov-2 传播的第一年。还报告了年龄在 45 岁以下的年轻女性中替比夫定使用率增加了 10%以上。在 24 个月后,对 204 名患者计算了 NEDA-3 状态,其中 120 名(58.8%)达到了 NEDA-3。在 36 个月时,92/160(56.8%)的患者也达到了 NEDA-3。在开始替比夫定治疗前两年的较低 ARR(p=0.026)、较低的基线年龄(p=0.05)和较低的 EDSS 评分(p=0.009)与达到 NEDA-3 相关。
我们的研究证实了替比夫定在临床环境中的应用发生了重大变化,特别是对于初治患者和年轻女性。