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阿根廷多发性硬化症患者使用富马酸二甲酯的临床疗效。

Clinical effectiveness of dimethyl fumarate in multiple sclerosis patients from Argentina.

机构信息

Department of Neurosciences, Neuroimmunology Unit, Hospital Aleman, Buenos Aires, Argentina.

CenRos, Neuroimmunology Clinic, INECO Neurociencias Oroño, Rosario, Santa Fe, Argentina.

出版信息

Neurol Sci. 2024 Dec;45(12):5833-5840. doi: 10.1007/s10072-024-07712-4. Epub 2024 Jul 31.

Abstract

BACKGROUND

We assessed the effectiveness, safety and patient-reported outcomes (PROs) of dimethyl fumarate (DMF) in real-world clinical practice in patients with multiple sclerosis (PwMS) from Argentina.

METHODS

We conducted a multicenter ambispective cohort study in Argentina between September 2020 and March 2023. Changes in annualized relapse rate (ARR), Expanded Disability Status Scale (EDSS) score, magnetic resonance imaging (MRI), no evidence of disease activity (NEDA), PROs (depression, anxiety, fatigue, burden of treatment and quality of life), and safety data were collected at clinical visits performed every 6 months for at least 24 months.

RESULTS

We included 161 PwMS (64% female). DMF treatment was associated with a significant reduction in ARR from baseline after 24 months of treatment (from 0.87 to 0.23, p < 0.001). Disability progression was observed in 27.9% vs. 9.3% pre- and post-DMF, and disability improvement was found in 13% of patients from baseline to month 24. MRI activity was significantly reduced compared with baseline. Fatigue, depression, and quality of life scores were significantly improved from baseline to 24 months. Flushing was the most frequent adverse event reported in 19.2%. No significant reduction was observed in the hospitalization rate pre- and post-DMF (19.8% vs. 5.6%, p = 0.32). During follow-up, 135 (83%) patients were relapse-free, 110 (68.3%) were MRI free activity (Gad + lesion) and 108 (67%) reached NEDA.

CONCLUSIONS

DMF significantly reduced disease activity in PwMS from Argentina with a good safety profile in real-world settings. A significant impact on the quality of life during follow-up was found.

摘要

背景

我们评估了二甲基富马酸(DMF)在阿根廷多发性硬化症(PwMS)患者真实世界临床实践中的疗效、安全性和患者报告结局(PROs)。

方法

我们在阿根廷进行了一项多中心前瞻性队列研究,时间为 2020 年 9 月至 2023 年 3 月。在至少 24 个月的每 6 个月一次的临床就诊时,收集了年度复发率(ARR)、扩展残疾状况量表(EDSS)评分、磁共振成像(MRI)、无疾病活动证据(NEDA)、PROs(抑郁、焦虑、疲劳、治疗负担和生活质量)以及安全性数据。

结果

我们纳入了 161 名 PwMS(64%为女性)。与基线相比,DMF 治疗 24 个月后 ARR 显著降低(从 0.87 降至 0.23,p<0.001)。与治疗前相比,治疗后有 27.9%的患者残疾进展,有 13%的患者残疾改善。与基线相比,MRI 活动明显减少。从基线到 24 个月,疲劳、抑郁和生活质量评分显著改善。报告最常见的不良反应是潮红,占 19.2%。DMF 治疗前后住院率无显著降低(19.8%比 5.6%,p=0.32)。在随访期间,135 名(83%)患者无复发,110 名(68.3%)患者 MRI 无活动(Gad+病变),108 名(67%)患者达到 NEDA。

结论

DMF 显著降低了阿根廷 PwMS 的疾病活动度,在真实环境中具有良好的安全性。在随访期间发现对生活质量有显著影响。

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