探索奥克立珠单抗对多发性硬化症患者耐药现象的影响：一项综合研究的启示

IF 2.9 3区医学 Q2 CLINICAL NEUROLOGY

Multiple sclerosis and related disorders Pub Date : 2024-10-11 DOI:10.1016/j.msard.2024.105939

Meral Seferoğlu , Abdulkadir Tunç , Ali Özhan Sıvacı , Gülnur Tekgöl Uzuner , Semra Mungan , Yılmaz İnanç , M. Fatih Yetkin , Bilgin Öztürk , Emine Rabia Koç , Şule Aydın Türkoğlu , Selma Aksoy , Şükran Yurtoğulları , Ömer Elçi

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引用次数: 0

摘要

背景奥克立珠单抗（OCR）能有效改变多发性硬化症（MS）患者的病程，但可能导致灌注前的 "消退现象"（WoP）。本研究探讨了这种现象在使用 OCR 的多发性硬化症患者中的发生率、发生时间和严重程度，以及相关症状和治疗满意度。方法我们在 11 个多发性硬化症中心开展了一项前瞻性多中心研究，涉及年龄在 18-70 岁、至少接受过两次 OCR 治疗的多发性硬化症患者。研究采用了一份调查问卷，内容包括人口统计学、临床和放射学数据、症状进展和治疗满意度。相当一部分患者出现了不同程度的 WoP：39.2% 的患者有时出现，25.9% 的患者通常出现，14.3% 的患者总是出现，其中 55.9% 的患者在下次服药前四周内出现症状。常见症状包括疲劳、行走困难和疼痛。对 334 名患者进行的亚组分析显示，78.1% 的患者出现了这些症状，这与患者的病程较短、最后一次服药前两次服药之间的间隔时间较长以及复发率较高有关（P>0.05）。这些见解强调了个性化治疗方案的必要性，以及对影响多发性硬化症治疗的因素进行更多研究的必要性。

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Exploring the impact of wearing-off phenomenon in ocrelizumab-treated multiple sclerosis patients: Insights from a comprehensive study

Background

Ocrelizumab (OCR) effectively modifies the disease course in multiple sclerosis (MS) patients but may cause a preinfusion "wearing-off phenomenon" (WoP). This study explored the prevalence, timing, and severity of this phenomenon in MS patients using the OCR, as well as the associated symptoms and treatment satisfaction.

Methods

We conducted a prospective multicenter study across 11 MS centers involving MS patients aged 18-70 years who had received at least two OCR doses. The study employed a questionnaire addressing demographic, clinical, and radiological data; symptom progression; and treatment satisfaction.

Results

Of the 409 patients included in the study, 406 participated. A significant portion experienced varying degrees of WoP: 39.2% sometimes, 25.9% usually, and 14.3% always, with 55.9% noting symptom onset over four weeks prior to their next dose. Common symptoms included fatigue, walking difficulties, and pain. Subgroup analysis of 334 patients revealed that 78.1% of patients experienced these effects, which correlated with shorter disease durations, a longer delay between the two doses before the last dose, and a greater rate of relapse (P>0.05).

Conclusion

The WoP of the OCR is prevalent and significant among MS patients and is influenced by the dosing interval, disease duration, and relapse rate. These insights underscore the need for personalized treatment schedules and more research into factors affecting MS management.

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来源期刊

Multiple sclerosis and related disorders CLINICAL NEUROLOGY-

CiteScore

5.80

自引率

20.00%

发文量

814

审稿时长

66 days

期刊介绍： Multiple Sclerosis is an area of ever expanding research and escalating publications. Multiple Sclerosis and Related Disorders is a wide ranging international journal supported by key researchers from all neuroscience domains that focus on MS and associated disease of the central nervous system. The primary aim of this new journal is the rapid publication of high quality original research in the field. Important secondary aims will be timely updates and editorials on important scientific and clinical care advances, controversies in the field, and invited opinion articles from current thought leaders on topical issues. One section of the journal will focus on teaching, written to enhance the practice of community and academic neurologists involved in the care of MS patients. Summaries of key articles written for a lay audience will be provided as an on-line resource. A team of four chief editors is supported by leading section editors who will commission and appraise original and review articles concerning: clinical neurology, neuroimaging, neuropathology, neuroepidemiology, therapeutics, genetics / transcriptomics, experimental models, neuroimmunology, biomarkers, neuropsychology, neurorehabilitation, measurement scales, teaching, neuroethics and lay communication.