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多发性硬化症中与复发生物学无关的疾病进展:一项真实世界研究

Progression independent of relapsing biology in multiple sclerosis: a real-word study.

作者信息

Yong Heather Y F, Camara-Lemarroy Carlos

机构信息

Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada.

Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.

出版信息

Front Neurol. 2025 May 29;16:1595929. doi: 10.3389/fneur.2025.1595929. eCollection 2025.

Abstract

Progression independent of relapse activity (PIRA) implies disability progression in people with relapsing-remitting multiple sclerosis (RRMS) secondary to neurodegeneration. Mechanistically and biologically PIRA could impact the traditional distinction between progressive and relapsing-MS. Herein, we estimated progression independent of relapsing biology (PIRB) in a cohort of 823 participants with clinically-isolated syndrome/RRMS in Calgary, Canada using a modified criterion [excluding relapses, inflammatory MRI activity, interim disability worsening/improvement over the observation period, and progression secondary to alternative causes including formal conversion to secondary-progressive MS]. PIRB was rare and rates remained consistent across disease-modifying therapies (3.75% dimethyl fumarate, 3.67% fingolimod, 3.72% ocrelizumab, 3.52% minocycline) despite varied rates of disability progression. PIRB may offer a practical alternative to the concept of PIRA.

摘要

独立于复发活动的疾病进展(PIRA)意味着复发缓解型多发性硬化症(RRMS)患者由于神经退行性变而出现残疾进展。从机制和生物学角度来看,PIRA可能会影响进展型MS和复发型MS之间的传统区分。在此,我们在加拿大卡尔加里的823名患有临床孤立综合征/RRMS的参与者队列中,使用一种修改后的标准[排除复发、炎症性MRI活动、观察期内临时残疾恶化/改善情况以及继发于包括正式转变为继发进展型MS在内的其他原因的疾病进展],估计了独立于复发生物学的疾病进展(PIRB)。PIRB很罕见,尽管残疾进展率各不相同,但在各种疾病修正治疗中其发生率保持一致(富马酸二甲酯为3.75%,芬戈莫德为3.67%,奥瑞珠单抗为3.72%,米诺环素为3.52%)。PIRB可能为PIRA概念提供一种实用的替代方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6859/12158712/c2e8fe59e18a/fneur-16-1595929-g001.jpg

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