Neurology:多发性硬化新药,可减缓脑萎缩

2021-01-28 Freeman MedSci原创

多发性硬化新药,可减缓脑萎缩

伊布地司特(Ibudilast)是一种小分子磷酸二酯酶(PDE)抑制剂,可抑制PDE3A、PDE4、PDE10和PDE11,对巨噬细胞抑制因子和toll样受体4有额外的抑制作用。

一项在297例复发缓解型多发性硬化症(MS)患者进行的2期安慰剂对照试验没有发现对年化复发率或新的MRI病变有好处。然而,在12个月时,观察到服用60mg剂量的患者脑体积百分比变化(PBVC)减少了33%(P=0.04)。后期分析表明,服用60mg(0.14;p=0.004)和30mg(0.17;p=0.036)剂量的人,与分配到安慰剂的人(0.24)相比,新病变演变为持续性腔隙的比例较低。有研究表明,对于那些接受积极治疗两年的人来说,残疾进展较少。

由于这些结果表明对脑萎缩、组织完整性和残疾有好处,因此在多发性硬化症进展期患者中进行了NeuroNEXT 102/二级和初级进展期Ibudilast NeuroNEXT试验(NN102/ SPRINT-MS)试验。

华盛顿大学的Robert T Naismith等人开展的SPRINT-MS,是一项为期96周的临床2期、安慰剂对照、多中心、随机、双盲、平行组试验,旨在评估Ibudilast在每天60至100mg剂量下,治疗原发性和继发性进展性MS的疗效和安全性。

主要终点,即通过脑实质分数(BPF)测量的全脑萎缩。

结果显示,共有129名参与者接受治疗,126名参与者作为安慰剂对照组。在37.2%的伊布地拉斯特和29.0%的安慰剂中观察到新的或扩大的T2病变(P = 0.82)。

96周时观察到新的T1低密度病变,伊布地拉斯特为33.3%,安慰剂为23.5%(p = 0.11)。和对照组相比,服用Ibudilast的患者,灰质萎缩减少35%(p = 0.038)。与安慰剂相比,Ibudilast组全脑萎缩的进展减慢20%(p = 0.08)。

这个研究的主要意义是,发现了Ibudilast治疗与灰质萎缩减少相关。伊布地拉斯特治疗与新发或扩大的T2病灶或新发T1病灶的减少无关。对脑容量的影响印证之前的结论——即Ibudilast似乎影响与神经退行性过程相关的标志物,但不影响炎症过程。


原文出处:

Effects of Ibudilast on MRI Measures in the Phase 2 SPRINT-MS Study,Robert T. Naismith, Robert A. Bermel, et al., on behalf of the SPRINT-MS investigators
Neurology Jan 2021, 96 (4) e491-e500; DOI: 10.1212/WNL.0000000000011314

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    2021-07-14 chendoc252
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    2021-05-06 MedSciZeng

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    2021-09-10 jml2009
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    2021-02-14 yinhl1978
  5. [GetPortalCommentsPageByObjectIdResponse(id=1695964, encodeId=4b221695964f4, content=<a href='/topic/show?id=03b98809697' target=_blank style='color:#2F92EE;'>#萎缩#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=88096, encryptionId=03b98809697, topicName=萎缩)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=53fc29868494, createdName=chendoc252, createdTime=Wed Jul 14 14:45:13 CST 2021, time=2021-07-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=963090, encodeId=ee3a963090ae, content=<a href='/topic/show?id=6b3a126981f' target=_blank style='color:#2F92EE;'>#Neurology#</a>点击进入话题查看更多相关文章 或评论时插入话题加入讨论, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12698, encryptionId=6b3a126981f, topicName=Neurology)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20221103/2796e00c9b4549e3b313ed9e7accc68f/b52d6d98bbe04782b5a4e2dd1ee80be2.jpeg, createdBy=078e1614372, createdName=MedSciZeng, createdTime=Thu May 06 13:46:34 CST 2021, time=2021-05-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1890212, encodeId=9fd01890212c0, content=<a href='/topic/show?id=760c430895a' target=_blank style='color:#2F92EE;'>#多发性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=43089, encryptionId=760c430895a, topicName=多发性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=04d6114, createdName=jml2009, createdTime=Fri Sep 10 05:45:13 CST 2021, time=2021-09-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2001223, encodeId=30ef200122395, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Sun Feb 14 00:45:13 CST 2021, time=2021-02-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1401220, encodeId=daa1140122015, content=<a href='/topic/show?id=3405850e3f4' target=_blank style='color:#2F92EE;'>#脑萎缩#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85073, encryptionId=3405850e3f4, topicName=脑萎缩)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/xdmCjlickSzn2cxg75bTZeYl2VYrTV6hibyMlic5XVFkibQbmFB7tK72afyxE4iclBhv7qd91qSk8Q6yicAcmErXRFxQ/132, createdBy=2c5d2304811, createdName=smartjoy, createdTime=Fri Jan 29 21:45:13 CST 2021, time=2021-01-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=920512, encodeId=a718920512ad, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/2BB0E90FFDA4FC816681902AA9BC71F6/100, createdBy=5b442207228, createdName=清华8035, createdTime=Thu Jan 28 08:15:46 CST 2021, time=2021-01-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=920510, encodeId=c0cf92051098, content=可以,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=31b35456678, createdName=ms9000001954232835, createdTime=Thu Jan 28 08:08:00 CST 2021, time=2021-01-28, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1695964, encodeId=4b221695964f4, content=<a href='/topic/show?id=03b98809697' target=_blank style='color:#2F92EE;'>#萎缩#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=88096, encryptionId=03b98809697, topicName=萎缩)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=53fc29868494, createdName=chendoc252, createdTime=Wed Jul 14 14:45:13 CST 2021, time=2021-07-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=963090, encodeId=ee3a963090ae, content=<a href='/topic/show?id=6b3a126981f' target=_blank style='color:#2F92EE;'>#Neurology#</a>点击进入话题查看更多相关文章 或评论时插入话题加入讨论, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12698, encryptionId=6b3a126981f, topicName=Neurology)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20221103/2796e00c9b4549e3b313ed9e7accc68f/b52d6d98bbe04782b5a4e2dd1ee80be2.jpeg, createdBy=078e1614372, createdName=MedSciZeng, createdTime=Thu May 06 13:46:34 CST 2021, time=2021-05-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1890212, encodeId=9fd01890212c0, content=<a href='/topic/show?id=760c430895a' target=_blank style='color:#2F92EE;'>#多发性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=43089, encryptionId=760c430895a, topicName=多发性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=04d6114, createdName=jml2009, createdTime=Fri Sep 10 05:45:13 CST 2021, time=2021-09-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2001223, encodeId=30ef200122395, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Sun Feb 14 00:45:13 CST 2021, time=2021-02-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1401220, encodeId=daa1140122015, content=<a href='/topic/show?id=3405850e3f4' target=_blank style='color:#2F92EE;'>#脑萎缩#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85073, encryptionId=3405850e3f4, topicName=脑萎缩)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/xdmCjlickSzn2cxg75bTZeYl2VYrTV6hibyMlic5XVFkibQbmFB7tK72afyxE4iclBhv7qd91qSk8Q6yicAcmErXRFxQ/132, createdBy=2c5d2304811, createdName=smartjoy, createdTime=Fri Jan 29 21:45:13 CST 2021, time=2021-01-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=920512, encodeId=a718920512ad, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/2BB0E90FFDA4FC816681902AA9BC71F6/100, createdBy=5b442207228, createdName=清华8035, createdTime=Thu Jan 28 08:15:46 CST 2021, time=2021-01-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=920510, encodeId=c0cf92051098, content=可以,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=31b35456678, createdName=ms9000001954232835, createdTime=Thu Jan 28 08:08:00 CST 2021, time=2021-01-28, status=1, ipAttribution=)]
    2021-01-28 清华8035

    学习了

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1695964, encodeId=4b221695964f4, content=<a href='/topic/show?id=03b98809697' target=_blank style='color:#2F92EE;'>#萎缩#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=88096, encryptionId=03b98809697, topicName=萎缩)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=53fc29868494, createdName=chendoc252, createdTime=Wed Jul 14 14:45:13 CST 2021, time=2021-07-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=963090, encodeId=ee3a963090ae, content=<a href='/topic/show?id=6b3a126981f' target=_blank style='color:#2F92EE;'>#Neurology#</a>点击进入话题查看更多相关文章 或评论时插入话题加入讨论, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12698, encryptionId=6b3a126981f, topicName=Neurology)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20221103/2796e00c9b4549e3b313ed9e7accc68f/b52d6d98bbe04782b5a4e2dd1ee80be2.jpeg, createdBy=078e1614372, createdName=MedSciZeng, createdTime=Thu May 06 13:46:34 CST 2021, time=2021-05-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1890212, encodeId=9fd01890212c0, content=<a href='/topic/show?id=760c430895a' target=_blank style='color:#2F92EE;'>#多发性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=43089, encryptionId=760c430895a, topicName=多发性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=04d6114, createdName=jml2009, createdTime=Fri Sep 10 05:45:13 CST 2021, time=2021-09-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2001223, encodeId=30ef200122395, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Sun Feb 14 00:45:13 CST 2021, time=2021-02-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1401220, encodeId=daa1140122015, content=<a href='/topic/show?id=3405850e3f4' target=_blank style='color:#2F92EE;'>#脑萎缩#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85073, encryptionId=3405850e3f4, topicName=脑萎缩)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/xdmCjlickSzn2cxg75bTZeYl2VYrTV6hibyMlic5XVFkibQbmFB7tK72afyxE4iclBhv7qd91qSk8Q6yicAcmErXRFxQ/132, createdBy=2c5d2304811, createdName=smartjoy, createdTime=Fri Jan 29 21:45:13 CST 2021, time=2021-01-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=920512, encodeId=a718920512ad, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/2BB0E90FFDA4FC816681902AA9BC71F6/100, createdBy=5b442207228, createdName=清华8035, createdTime=Thu Jan 28 08:15:46 CST 2021, time=2021-01-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=920510, encodeId=c0cf92051098, content=可以,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=31b35456678, createdName=ms9000001954232835, createdTime=Thu Jan 28 08:08:00 CST 2021, time=2021-01-28, status=1, ipAttribution=)]
    2021-01-28 ms9000001954232835

    可以,学习了

    0

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