Neurology:波尼莫德治疗复发缓解型多发性硬化症的长期疗效

2022-08-27 MedSci原创 MedSci原创

使用波尼莫德20mg对多发性硬化症的控制效果维持了大约8年,没有发现新的安全问题。

近期,发表在Neurology杂志上的研究利用对复发性多发性硬化症(RRMS)患者的2期核心研究和扩展研究的综合数据分析,评估10、20和40mg波尼莫德的剂量反应关系以及波尼莫德20mg的长期疗效和安全性。

在核心研究中,464名患者被随机分配(1:1:1:1):安慰剂(n = 121)、10毫克(n = 108)、20毫克(n = 116)或40mg波尼莫德(n = 119),每天一次,为期24周。完成核心研究的患者过渡到扩展研究,其中有治疗期1(TP1;长达96周)和TP2及TP3(长达432周)。在TP1结束时,40mg的剂量因耐受性低而停用,随后在TP2结束时,10mg的剂量因与20mg相比效益风险较低而停用。所有患者在TP2期间接受10或20mg,随后在TP3接受20毫克。评估了年复发率(ARR)、6个月确认残疾累积(CDA)、首次确认复发时间、MRI结果和安全性。

共有435名患者接受了≥1个剂量的波尼莫德(第一个随机剂量:10mg=139,20mg=145,和40mg=151)。截至2019年3月31日,214名患者仍在接受波尼莫德治疗。接触波尼莫德的中位数(范围)为7.95(0-9.36)年。波尼莫德20mg,从Core到TP3结束,与持续的低临床活性有关(确认复发的ARR=0.154;在第432周,确认复发的Kaplan-Meier估计值为43.9%,6个月的CDA为20.4%)和MRI疾病活动,超过64%的患者仍然没有确认复发。

综上,使用波尼莫德20mg对多发性硬化症的控制效果维持了大约8年,没有发现新的安全问题。

参考文献:

Long-term Treatment With Ponesimod in Relapsing-Remitting Multiple Sclerosis Results From Randomized Phase 2b Core and Extension Studies. https://doi.org/10.1212/WNL.0000000000200606

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