多发性硬化症老年患者的治疗中断。
Treatment discontinuation in older people with multiple sclerosis.
机构信息
Department of Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
出版信息
Curr Opin Neurol. 2024 Jun 1;37(3):220-227. doi: 10.1097/WCO.0000000000001272. Epub 2024 Apr 3.
PURPOSE OF REVIEW
The aim of this review was to examine the evidence for disease-modifying therapies (DMTs) discontinuation in older people with multiple sclerosis (MS). We first summarized aging-associated biological changes that influence MS progression and DMT effectiveness, and then summarized recent evidence in evaluating clinical outcomes of discontinuing DMTs in older people with MS.
RECENT FINDINGS
Recent findings provide mixed evidence regarding the outcomes of DMT discontinuation in older people with MS. Retrospective observational studies suggested older age and longer stable duration on DMT before DMT discontinuation were associated with lower risk of relapse in people with MS. However, one randomized clinical trial did not demonstrate the noninferiority of DMT discontinuation.
SUMMARY
The available clinical evidence examining DMT discontinuation in older people with MS remains inconclusive. More robust evidence from clinical trials and real-world data will be necessary to guide clinical decisions regarding DMT discontinuation in older people with MS.
目的综述
本综述旨在研究多发性硬化症（MS）老年患者中疾病修正疗法（DMT）停药的证据。我们首先总结了与 MS 进展和 DMT 疗效相关的与年龄相关的生物学变化，然后总结了最近在评估 MS 老年患者 DMT 停药的临床结局方面的证据。
最新发现
最近的研究结果提供了关于 MS 老年患者 DMT 停药结局的混杂证据。回顾性观察性研究表明，DMT 停药前年龄较大和 DMT 稳定持续时间较长与 MS 患者复发风险降低相关。然而，一项随机临床试验并未证明 DMT 停药的非劣效性。
总结
目前关于 MS 老年患者 DMT 停药的临床证据尚无定论。需要来自临床试验和真实世界数据的更有力证据来指导 MS 老年患者 DMT 停药的临床决策。
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