多发性硬化疾病修正治疗初治模式探索的真实世界研究

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【中图分类号】R741【文献标志码】A【收稿日期】2024-10-23

Exploration of the initial patterns of disease-modifying treatment in patients with multiple sclerosis：a real-world study

YangXiaolin，FengJinzhou，QinXinyue （Department of Neurology，The First Affiliated Hospital of Chongqing Medical University）

【Abstract】Objective：Toexploretheinitiationpatersof disease-modifyingtreatment（DMT）inpatientswithmultiplesclerosis （MS）inChongqing，China.Methods：Theclinicalandimagingdataofpatientswithrelapsing-remitingMS（RRMS）whocommenced DMT（teriflunomide，imethmarate，sngosi-ospatercetormoulators，tumuab）forthefisttieatteept mentofNeurology，TheFirstAfiliatedHospitalofhongqingMedicalUniversiyfromNovember2O18toJanuary2O24wereobtained. Theanalysisfousdontedistrbutio，ersisteceatendsafetyofiitialDpresciptios，osttreatmentdiseaseactivitnd riskfactorsafectingdiseaseactivityResults：Atotalof138patientsithRMSwereincluded.TdistributionofinitialDprscriptions was as follows ： teriflunomide（46.4 % ），dimethyl fumarate（20.3 % ），sphingosine-1-phosphate receptor modulators（21.7 % ）， and ofatumumab（11.6 % ）.Throughout the follow-up period， 72.5% of patients complied with their initial prescription，whereas 23.2% （20 of patientsalteredtheirtreatments，predominantlytransitioningtoofatumumab.Nodrug-relateddeathorospitalizationwasdocumentedduringtheuseofthefourDMTprescriptions.However，spingosine-1-phosphatereeptormodulatorsexhibitedthehighstincidence of adverse events（ 43.3% ）.An analysis of post-treatment disease activity in115 patients indicated that 47.O% of patients displayeddiseaseactivity.IndependentriskfactorsfordiseaseactivitycomprisedincompleterecoeryaftertheinitialonsetofM（dds ratio[OR]=3.645，95%CI=1.321-10.06，P=0.013）and smoking（0R=10.052，95%CI=1.025-98.556， P =0.048）.Conclusion：In the lastfiveyears，temajorityofiitialDprescriptiosforpatintsithRMSinCongqng，China，erelow-tomderatec drugs.Aconsiderablepercentageof patients exhibited diseaseactivitydespitecommencing DMT.PromptcommencementofhighefficacyDMT maybemore effective in diminishingdiseaseactivity and postponing disability progression in patients with MS.

【Keywords】multiple sclerosis;disease-modifying treatment;treatmentoutcome

多发性硬化（multiplesclerosis，MS）是一种自身免疫介导的中枢神经系统炎性脱髓鞘疾病，是年轻人最常见的非外伤性致残性疾病之一，全世界约有280万患者，中国整体发病率为0.235/10万人年[3]。（剩余16164字）