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特立氟胺治疗复发缓解型多发性硬化症患者两年的生活质量真实世界评估:希腊AURELIO研究的患者报告结局

Real-World Assessment of Quality of Life in Patients with Relapsing Remitting Multiple Sclerosis Treated with Teriflunomide for Two Years: Patient-Reported Outcomes from the AURELIO Study in Greece.

作者信息

Dardiotis Efthymios, Perpati Georgia, Borsos Mariann, Nikolaidis Ioannis, Tzanetakos Dimitrios, Deretzi Georgia, Koutlas Evangelos, Kilidireas Constantinos, Mitsikostas Dimos Dimitrios, Hadjigeorgiou Georgios, Grigoriadis Nikolaos

机构信息

Department of Neurology, University Hospital of Larissa, University of Thessaly, Larissa, Greece.

Sanofi Genzyme Greece, Kallithea, Greece.

出版信息

Neurol Ther. 2022 Sep;11(3):1375-1390. doi: 10.1007/s40120-022-00384-2. Epub 2022 Jul 13.

Abstract

INTRODUCTION

Multiple sclerosis (MS) is a highly heterogeneous inflammatory disease of the central nervous system. Patient-reported outcomes (PROs) in a real-world clinical setting can provide detailed information about MS from the patient's perspective. PROs were used here to assess quality of life (QoL), treatment satisfaction, clinical efficacy, and safety outcomes in a Greek cohort of relapsing remitting MS (RRMS) patients treated with oral teriflunomide (14 mg/day).

METHODS

AURELIO was a 2-year, prospective, observational study whose QoL primary endpoint was assessed with the Multiple Sclerosis Impact Scale (MSIS-29). Secondary endpoints included analyses of Patient Determined Disease Steps (PDDS), Treatment Satisfaction Questionnaire for Medication (TSQM), Expanded Disability Status Scale (EDSS), annualized relapse rate (ARR), adherence, and safety outcomes.

RESULTS

AURELIO enrolled 282 patients (62.8% female; mean age 44.8 [SD ± 11] years; EDSS 2.0 [SD ± 1.6]; 44.6% treatment-naïve), with 212 patients (75%) remaining on treatment at study end. MSIS-29 total scores remained stable, while the MSIS-29 psychological scale showed significant improvement (p = 0.0015) at 2 years vs. baseline. TSQM scores at 2 years showed significant improvements in effectiveness (+ 6.6, p = 0.0001), convenience (+ 1.9, p = 0.0256), and global satisfaction (+ 8.1, p = 0.0001) vs. baseline. Disease progression was stable as indicated by non-significant changes in PDDS and EDSS vs. baseline. The ARR was low at 0.065, with a slightly higher ARR in previously treated (0.070) vs. naïve patients (0.058). Adherence was high at > 90%. Overall, 91 patients (32.3%) in the study reported a total of 215 safety events (32 serious, of which 21 were classified as mild-moderate). No new safety signals were observed.

CONCLUSIONS

These data highlight the importance of PROs to facilitate personalized treatment strategies in MS. In line with other teriflunomide studies, AURELIO showed stable QoL, efficacy and safety outcomes, and good treatment satisfaction both in treatment-naïve and previously treated patients in this Greek cohort of patients with RRMS.

摘要

引言

多发性硬化症(MS)是一种中枢神经系统高度异质性的炎症性疾病。在真实临床环境中患者报告的结局(PROs)可以从患者角度提供有关MS的详细信息。在此使用PROs评估希腊一组接受口服特立氟胺(14毫克/天)治疗的复发缓解型MS(RRMS)患者的生活质量(QoL)、治疗满意度、临床疗效和安全性结局。

方法

AURELIO是一项为期2年的前瞻性观察性研究,其QoL主要终点通过多发性硬化症影响量表(MSIS-29)进行评估。次要终点包括对患者确定的疾病阶段(PDDS)、药物治疗满意度问卷(TSQM)、扩展残疾状态量表(EDSS)、年化复发率(ARR)、依从性和安全性结局的分析。

结果

AURELIO纳入了282例患者(62.8%为女性;平均年龄44.8[标准差±11]岁;EDSS为2.0[标准差±1.6];44.6%为初治患者),研究结束时212例患者(75%)仍在接受治疗。MSIS-29总分保持稳定,而MSIS-29心理量表在2年时与基线相比有显著改善(p = 0.0015)。2年时TSQM评分在有效性(+6.6,p = 0.0001)、便利性(+1.9,p = 0.0256)和总体满意度(+8.1,p = 0.0001)方面与基线相比有显著改善。与基线相比,PDDS和EDSS无显著变化,表明疾病进展稳定。ARR较低,为0.065,既往治疗患者的ARR(0.070)略高于初治患者(0.058)。依从性较高,>90%。总体而言,该研究中的91例患者(32.3%)共报告了215起安全事件(32起严重,其中21起被分类为轻-中度)。未观察到新的安全信号。

结论

这些数据突出了PROs在促进MS个性化治疗策略方面的重要性。与其他特立氟胺研究一致,AURELIO在该希腊RRMS患者队列的初治和既往治疗患者中均显示出稳定的QoL、疗效和安全性结局,以及良好的治疗满意度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/709f/9338205/caced3ef17d9/40120_2022_384_Fig1_HTML.jpg

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