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利妥昔单抗治疗多发性硬化症。墨西哥一家三级护理医院的经验。

Rituximab in the treatment of multiple sclerosis. Experience of a tertiary care hospital in Mexico.

机构信息

Neurosciences Department, Hospital Regional de Alta Especialidad Bajío.

Department of Internal Medicine, Hospital Regional de Alta Especialidad Bajío.

出版信息

Gac Med Mex. 2023;159(3):180-184. doi: 10.24875/GMM.M23000769.

Abstract

BACKGROUND

Multiple sclerosis is a chronic, autoimmune, degenerative disease. Therapies targeting B-cells have been shown to be effective in its treatment; however, there are few studies evaluating their efficacy in the Mexican population.

OBJECTIVE

To evaluate the clinical impact of rituximab in patients with newly-diagnosed relapsing-remitting multiple sclerosis (RRMS).

MATERIAL AND METHODS

Real life, descriptive study, in which rituximab was evaluated as treatment for RRMS over a 24-month period. Pre- and post-treatment clinical variables were analyzed; a comparison was made between treatment-naïve and non-treatment-naïve patients.

RESULTS

Twenty-eight patients with RRMS were included. Mean age at diagnosis was 30.7 years, and 22 patients were treatment-naïve (78.5 %). After 24 months, there was a mean reduction of 1.8 points in the EDSS scale and a decrease in the number of active lesions on magnetic resonance imaging; a significant difference in both variables could be established (p < 0.05). However, the logistic regression model did not show a relationship between the variables for achieving NEDA-3 criteria. No serious adverse events were observed.

CONCLUSIONS

Treatment with rituximab resulted in significant clinical and radiological improvement in treatment-naïve and non-treatment-naïve Mexican patients with RRMS.

摘要

背景

多发性硬化症是一种慢性、自身免疫性、退行性疾病。针对 B 细胞的治疗方法已被证明在其治疗中有效;然而,评估它们在墨西哥人群中的疗效的研究较少。

目的

评估利妥昔单抗在新诊断的复发缓解型多发性硬化症(RRMS)患者中的临床影响。

材料和方法

这是一项真实世界的描述性研究,评估了利妥昔单抗作为 RRMS 治疗方法的 24 个月的疗效。分析了治疗前后的临床变量;比较了治疗初治和非治疗初治患者。

结果

共纳入 28 例 RRMS 患者。诊断时的平均年龄为 30.7 岁,22 例患者为治疗初治(78.5%)。24 个月后,EDSS 量表平均降低 1.8 分,磁共振成像上的活跃病变数量减少;这两个变量都有显著差异(p<0.05)。然而,逻辑回归模型并未显示达到 NEDA-3 标准的变量之间存在关系。未观察到严重不良事件。

结论

利妥昔单抗治疗新诊断的 RRMS 墨西哥初治和非初治患者,可显著改善临床和放射学结果。

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