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在复发型多发性硬化症患者中,克拉屈滨片可改善 2 年以上的生活质量:CLARIFY-MS 研究。

Improvements in quality of life over 2 years with cladribine tablets in people with relapsing multiple sclerosis: The CLARIFY-MS study.

机构信息

INSERM U 1215, University of Bordeaux, Bordeaux, France.

Unit of Neuroepidemiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.

出版信息

Mult Scler. 2023 Dec;29(14):1808-1818. doi: 10.1177/13524585231205962. Epub 2023 Nov 18.

DOI:10.1177/13524585231205962
PMID:37978852
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10687821/
Abstract

BACKGROUND

Multiple sclerosis (MS) negatively affects health-related quality of life (HRQoL).

OBJECTIVE

To evaluate HRQoL in people with highly active relapsing MS treated with cladribine tablets (CladT; 3.5 mg/kg cumulative dose over 2 years) in CLARIFY-MS.

METHODS

Changes in the MS quality of life (MSQoL)-54 scores were analysed using a repeated mixed-effects linear model. Subgroup analyses were performed for participants who were pretreatment-naïve and those pretreated with disease-modifying therapies (DMTs) before initiating CladT. Safety and tolerability of CladT were also assessed.

RESULTS

MSQoL-54 physical (mean change = 4.86; 95% confidence interval (CI) = 3.18, 6.53) and mental health (4.80; 95% CI = 3.13, 6.46) composite scores (primary endpoints) showed significant improvement at Month 24 versus Baseline ( < 0.0001). Changes in the MSQoL-54 scores were consistent across the pretreatment-naïve and DMT-pretreated subgroups. No new severe or opportunistic infections occurred. Most post-baseline lymphopenia events were Grade 1-2 in severity. Transient Grade-3 lymphopenia was observed in 19.7% (95/482) of participants. Grade-4 lymphopenia was not observed.

CONCLUSIONS

CladT treatment significantly improved the mean MSQoL-54 physical and mental health composite scores over 2 years. CladT efficacy in HRQoL, relapse rates and Expanded Disability Status Scale scores demonstrates its multidimensional effects in MS treatment.

摘要

背景

多发性硬化症(MS)会对健康相关生活质量(HRQoL)产生负面影响。

目的

在 CLARIFY-MS 中评估接受克拉屈滨片(CladT;2 年内累积剂量 3.5mg/kg)治疗的高度活跃复发型 MS 患者的 HRQoL。

方法

使用重复混合效应线性模型分析 MS 生活质量(MSQoL)-54 评分的变化。对预处理初治患者和在开始使用克拉屈滨前接受过疾病修正疗法(DMT)的患者进行亚组分析。还评估了克拉屈滨的安全性和耐受性。

结果

MSQoL-54 身体(平均变化=4.86;95%置信区间(CI)=3.18,6.53)和心理健康(4.80;95%CI=3.13,6.46)综合评分(主要终点)在 24 个月时与基线相比有显著改善(<0.0001)。在预处理初治和 DMT 预处理亚组中,MSQoL-54 评分的变化是一致的。没有发生新的严重或机会性感染。大多数基线后淋巴细胞减少事件的严重程度为 1-2 级。19.7%(95/482)的患者出现一过性 3 级淋巴细胞减少。未观察到 4 级淋巴细胞减少。

结论

克拉屈滨治疗在 2 年内显著改善了 MSQoL-54 身体和心理健康综合评分的平均值。克拉屈滨在 HRQoL、复发率和扩展残疾状态量表评分方面的疗效表明其在 MS 治疗中具有多维作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9e8/10687821/4bdeceac9b91/10.1177_13524585231205962-fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9e8/10687821/71b0979d1e31/10.1177_13524585231205962-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9e8/10687821/9852ef40c9b0/10.1177_13524585231205962-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9e8/10687821/ce5d22019172/10.1177_13524585231205962-fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9e8/10687821/4bdeceac9b91/10.1177_13524585231205962-fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9e8/10687821/71b0979d1e31/10.1177_13524585231205962-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9e8/10687821/9852ef40c9b0/10.1177_13524585231205962-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9e8/10687821/ce5d22019172/10.1177_13524585231205962-fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9e8/10687821/4bdeceac9b91/10.1177_13524585231205962-fig4.jpg

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