The Danish Multiple Sclerosis Registry, Danish Multiple Sclerosis Research Center, Copenhagen University Hospital, Glostrup, Denmark
The Danish Multiple Sclerosis Registry, Danish Multiple Sclerosis Research Center, Copenhagen University Hospital, Glostrup, Denmark.
J Neurol Neurosurg Psychiatry. 2024 Sep 17;95(10):979-987. doi: 10.1136/jnnp-2023-333265.
Clinicians frequently rely on relapse counts, T2 MRI lesion load (T2L) and Expanded Disability Status Scale (EDSS) scores to guide treatment decisions for individuals diagnosed with multiple sclerosis (MS). This study evaluates how these factors, along with age and sex, influence prognosis during treatment with teriflunomide (TFL).
We conducted a nationwide cohort study using data from the Danish Multiple Sclerosis Registry.Eligible participants had relapsing-remitting MS or clinically isolated syndrome and initiated TFL as their first treatment between 2013 and 2019. The effect of age, pretreatment relapses, T2L and EDSS scores on the risk of disease activity on TFL were stratified by sex.
In total, 784 individuals were included (57.4% females). A high number of pretreatment relapses (≥2) was associated with an increased risk of disease activity in females only (OR and (95% CI): 1.76 (1.11 to 2.81)). Age group 50+ was associated with a lower risk of disease activity in both sexes (OR females=0.28 (0.14 to 0.56); OR males=0.22 (0.09 to 0.55)), while age 35-49 showed a different impact in males and females (OR females=0.79 (0.50 to 1.23); OR males=0.42 (0.24 to 0.72)). EDSS scores and T2L did not show any consistent associations.
A high number of pretreatment relapses was only associated with an increased risk of disease activity in females, while age had a differential impact on the risk of disease activity according to sex. Clinicians may consider age, sex and relapses when deciding on TFL treatment.
临床医生经常依赖复发次数、T2 磁共振成像病变负荷（T2L）和扩展残疾状况量表（EDSS）评分来指导多发性硬化症（MS）患者的治疗决策。本研究评估了这些因素以及年龄和性别如何影响替比夫定（TFL）治疗期间的预后。
我们使用丹麦多发性硬化症登记处的数据进行了一项全国性队列研究。合格的参与者患有复发缓解型多发性硬化症或临床孤立综合征，并在 2013 年至 2019 年间首次接受 TFL 治疗。根据性别对 T2L 和 EDSS 评分对 TFL 疾病活动风险的影响进行了年龄、预处理复发次数的分层。
共纳入 784 名患者（57.4%为女性）。预处理复发次数较多（≥2）仅与女性疾病活动风险增加相关（比值比及其 95%置信区间：1.76（1.11 至 2.81））。50 岁以上年龄组在两性中均与疾病活动风险降低相关（女性 OR=0.28（0.14 至 0.56）；男性 OR=0.22（0.09 至 0.55）），而 35-49 岁年龄组在男性和女性中的影响不同（女性 OR=0.79（0.50 至 1.23）；男性 OR=0.42（0.24 至 0.72））。EDSS 评分和 T2L 没有显示出任何一致的关联。
高预处理复发次数仅与女性疾病活动风险增加相关，而年龄对疾病活动风险的影响因性别而异。临床医生在决定 TFL 治疗时可以考虑年龄、性别和复发次数。
