关于使用克拉利宾片治疗复发性多发性硬化症的实用指南:来自卡塔尔的专家意见。

IF 2.1 Q3 CLINICAL NEUROLOGY
Degenerative neurological and neuromuscular disease Pub Date : 2023-12-13 eCollection Date: 2023-01-01 DOI:10.2147/DNND.S433459
Dirk Deleu, Beatriz Garcia Canibano, Osama Elalamy, Mohamed Sayed Abdelmoneim, Amir Boshra
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引用次数: 0

摘要

用于治疗复发性多发性硬化症(RMS)的高效改变病情疗法(DMT)越来越多,增加了对患者进行个体化管理的可能性,但也增加了治疗方案设计的复杂性。免疫重建疗法(IRT)的长期应用得到了越来越多真实世界研究数据库的支持,这些研究为这种方法的长期安全性和有效性提供了重要信息。克拉利宾片(CladT)是一种每年短期治疗两个疗程的免疫再建疗法,大多数患者在治疗后数年内没有明显的多发性硬化症疾病活动。随着临床证据的不断积累,是否以及如何在头两年治疗后对患者进行治疗仍是一个争论不休的问题。我们是一群在卡塔尔治疗 RMS 患者的神经科医生,根据过去 5 年的治疗经验,就 CladT 疗法的应用和长期管理提出了专家共识建议。这些建议包括针对第 3 年和第 4 年(即首次服用 CladT 后最多 4 年)有多发性硬化症疾病活动的患者,以及针对随后几年有或无多发性硬化症疾病活动的患者的实用建议。我们相信,我们的建议将有助于确保以 CladT 为基础的 IRT 得到最佳应用,从而为患者带来潜在的益处,使其能够长期摆脱 MS 疾病症状和定期应用免疫抑制 DMT 的负担。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Practical Guidance on the Use of Cladribine Tablets in the Management or Relapsing Multiple Sclerosis: Expert Opinion from Qatar.

The increasing availability of high-efficacy disease-modifying therapies (DMT) for the management of relapsing multiple sclerosis (RMS) has increased the potential for individualised patient management but has added complexity to the design of treatment regimens. The long-term application of immune reconstitution therapy (IRT) is supported by an increasing database of real world studies that have added important information on the long-term safety and efficacy of this approach. Cladribine tablets (CladT) is an IRT given as two annual short courses of treatment, following which a majority of patients then demonstrate no significant MS disease activity over a period of years. Whether, and how, to treat patients beyond the first two years of treatment remains a matter for debate, as clinical evidence accumulates. We, a group of neurologists who manage people with RMS in Qatar, provide our expert consensus recommendations on the application and long-term management of CladT therapy based on our experience with treatment in the last 5 years. These include pragmatic recommendations for people with MS disease activity in years 3 and 4 (ie up to four years following first dose of CladT), and for people with or without MS disease activity in subsequent years. We believe our recommendations will help to ensure the optimal application of CladT-based IRT, with the potential benefit for the patient of achieving prolonged periods free of both MS disease symptoms and the burden of regular applications of immunosuppressive DMT.

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