背景:这项研究调查了芬戈莫德(FGL)治疗停药后RRMS患者在了解复发性疾病活动(RDA)动力学方面的差距。目的是研究停止FGL后RRMS患者的RDA,旨在提高对治疗后疾病进展的管理和理解。
方法:在这个多中心中,回顾性研究,数据来自土耳其9个中心的944名18-55岁的RRMS患者中的172名,谁停止了FGL治疗,进行了分析。收集的数据包括EDSS得分,年复发率(ARR),淋巴细胞计数,和MRI检查结果,在6个月时进行随访评估,1年,长达2年。
结果:在31.9%的患者中观察到RDA,回弹和再活化的发生率分别为20.3%和11.6%,分别。诸如年龄较小的因素,治疗持续时间较长,较低的淋巴细胞计数,和更高的病变负担增加RDA风险。值得注意的是,52.9%的孕妇经历了RDA(占整个RDA组的16.4%),在六个中发生反弹,在三个中发生重新激活。RDA患者的无用药间隔较长,ARR增加。中断的原因各不相同,疾病进展与较低的RDA风险有关。
结论:研究结果强调了RRMS患者FGL停药后个性化管理和警惕监测的必要性,提供对RDA风险因素的关键见解,以及停止治疗之间复杂的相互作用,怀孕,和疾病进展。
BACKGROUND: This study investigates the gap in understanding the dynamics of recurring disease activity (RDA) in RRMS patients after fingolimod (FGL) treatment discontinuation. The aim is to investigate RDA in RRMS patients after stopping FGL, aiming to improve management and comprehension of disease progression post-treatment.
METHODS: In this multicenter, retrospective study, data from 172 of 944 RRMS patients aged 18-55, across nine centers in Turkey, who discontinued FGL treatment, were analyzed. The collected data included EDSS scores, annualized relapse rates (ARR), lymphocyte counts, and MRI findings, with follow-up assessments conducted at 6 months, 1 year, and up to 2 years.
RESULTS: RDA was observed in 31.9 % of patients, with incidences of rebound and reactivation at 20.3 % and 11.6 %, respectively. Factors like younger age, longer treatment duration, lower lymphocyte counts, and higher lesion burden increased RDA risk. Notably, 52.9 % of pregnant patients experienced RDA (16.4 % of the overall RDA group), with rebound occurring in six and reactivation in three. Patients with RDA had longer medication-free intervals and increased ARR. Discontinuation reasons varied, with disease progression linked to a lower RDA risk.
CONCLUSIONS: Findings highlight the necessity for personalized management and vigilant monitoring after FGL discontinuation in RRMS patients, offering critical insights into RDA risk factors, and the complex interplay between treatment cessation, pregnancy, and disease progression.