JAMA Neurol:利妥昔单抗、那他珠单抗、芬戈莫德治疗MS感染风险差异研究

2019-10-14 MedSci MedSci原创

研究发现,MS患者感染风险普遍增加,这一点因治疗而异,干扰素β和GA的感染风险最低;在较新的治疗方法中,利妥昔单抗的严重感染风险最高

近日研究考察了多发性硬化症(MS)治疗中与疾病相关的严重感染的风险。

研究在瑞典开展,比较复发缓解型MS患者使用利妥昔单抗、那他珠单抗、芬戈莫德、干扰素β-醋酸格拉替雷(GA)后的严重感染风险。严重感染被定义为所有导致住院的感染。其他结果包括门诊治疗抗生素或疱疹抗病毒药物使用。

6421名患者参与研究,其中利妥昔单抗组3260人,那他珠单抗组1588人,芬戈莫德1535人,干扰素β/GA 组2217人,对照组42645人。6421人总计接受8600次治疗,开始治疗的平均年龄为35.0岁-40.4岁,女性6186人。服用干扰素β-GA的MS患者的感染率高于普通人群(发病率为8.9 vs 5.2/***-年),而服用芬戈莫德 (14.3)、那他珠单抗(11.4)和利妥昔单抗(11.4)的患者的感染风险更高。经调整后,与干扰素β和GA相比,使用利妥昔单抗后感染风险仍很高(HR: 1.70),但芬戈莫德(HR:1.30)与那他珠单抗(HR:1.12)则无显著差异。与此形成对照的是,在利妥昔单抗治疗期间使用疱疹抗病毒药物与干扰素β和GA相似,且低于那他珠单抗(HR:1.82)和芬戈莫德(HR:1.71)。

研究发现,MS患者感染风险普遍增加,这一点因治疗而异,干扰素β和GA的感染风险最低;在较新的治疗方法中,利妥昔单抗的严重感染风险最高。

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    2019-11-26 yinhl1978
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