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Neurology:β-干扰素治疗多发性硬化症安全吗?

2017-07-04 易湛苗 环球医学资讯

2017年6月,发表在《Neurology》的由加拿大科学家进行的系列巢式病例对照研究,评估了β-干扰素在多发性硬化症(MS)中的安全性。

2017年6月,发表在《Neurology》的由加拿大科学家进行的系列巢式病例对照研究,评估了β-干扰素在多发性硬化症(MS)中的安全性。

目的:旨在利用加拿大英属哥伦比亚基于人群的健康管理数据,研究干扰素-β(IFN-β)与潜在不良事件之间的相关性。

方法:患者的入组标准为:复发缓解型多发性硬化症(RRMS)、在英属哥伦比亚多发性硬化症门诊中登记(1995~2004年),随访至死亡、离开英属哥伦比亚、使用非IFN-β药物改善病情或2008年12月31日。评估每种潜在不良事件的发生率(从医生和医院声明中预先选取和定义ICD-9/10诊断编码)。巢式病例对照研究用来评估至少30个病例发生的每种潜在不良事件与使用IFN-β的关系。根据年龄(±5岁)、性别和入组队列年将病例和高达20个随机选择的对照(发病密度抽样)进行配对。使用条件逻辑回归评估比值比(OR)及其95%置信区间(95% CI),并调整了入组队列时的年龄。

结果:2485例符合条件的患者中,77.9%为女性,1031例在随访期接受IFN-β治疗。发病率分析表明,47种潜在不良事件中的27种发生在至少30个病例上。既往暴露于IFN-β的患者比对照更可能发生卒中(OR,1.83,95% CI,1.16~2.89)、偏头痛(OR,1.55,95% CI,1.18~2.04)、抑郁(OR,1.33,95% CI,1.13~1.56)和血液学异常(OR,1.32,95% CI,1.01~1.72)。

结论:RRMS患者中,IFN-β与卒中和偏头痛风险分别增加1.8倍和1.6倍相关,与抑郁和血液学异常风险增加1.3倍相关。

原始出处
de Jong HJI, Kingwell E, Shirani A, et al. Evaluating the safety of beta-interferons in MS: A series of nested case-control studies.Neurology. 2017 Jun 13;88(24):2310-2320. doi: 10.1212/WNL.0000000000004037. Epub 2017 May 12.

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    2018-03-30 jml2009
  2. [GetPortalCommentsPageByObjectIdResponse(id=1889758, encodeId=97221889e58c0, 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=66, 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 Mar 30 14:53:00 CST 2018, time=2018-03-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2000021, encodeId=af3020000210a, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, 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 Aug 27 17:53:00 CST 2017, time=2017-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1982963, encodeId=dba8198296382, content=<a href='/topic/show?id=a7a7e359478' target=_blank style='color:#2F92EE;'>#硬化症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73594, encryptionId=a7a7e359478, topicName=硬化症)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a691420, createdName=30397604, createdTime=Wed Sep 27 20:53:00 CST 2017, time=2017-09-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=218546, encodeId=48a1218546d6, content=学习一下谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzaiabIFicf63hKvVMjL6aJlx4yX4UcXmzX9DyibCRcicq0QtCRWMaQKh8MYjE1D3EKUBopgiaGWYuqbeR/0, createdBy=0c2b1999806, createdName=三生有幸9135, createdTime=Tue Jul 04 16:03:24 CST 2017, time=2017-07-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=218539, encodeId=57a421853972, content=学习了新知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Tue Jul 04 15:54:46 CST 2017, time=2017-07-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=218519, encodeId=b5772185199b, content=谢谢分享,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Tue Jul 04 14:46:56 CST 2017, time=2017-07-04, status=1, ipAttribution=)]
    2017-08-27 yinhl1978
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    2017-07-04 三生有幸9135

    学习一下谢谢分享

    0

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    2017-07-04 Y—xianghai

    学习了新知识

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1889758, encodeId=97221889e58c0, 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=66, 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 Mar 30 14:53:00 CST 2018, time=2018-03-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2000021, encodeId=af3020000210a, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, 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 Aug 27 17:53:00 CST 2017, time=2017-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1982963, encodeId=dba8198296382, content=<a href='/topic/show?id=a7a7e359478' target=_blank style='color:#2F92EE;'>#硬化症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73594, encryptionId=a7a7e359478, topicName=硬化症)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a691420, createdName=30397604, createdTime=Wed Sep 27 20:53:00 CST 2017, time=2017-09-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=218546, encodeId=48a1218546d6, content=学习一下谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzaiabIFicf63hKvVMjL6aJlx4yX4UcXmzX9DyibCRcicq0QtCRWMaQKh8MYjE1D3EKUBopgiaGWYuqbeR/0, createdBy=0c2b1999806, createdName=三生有幸9135, createdTime=Tue Jul 04 16:03:24 CST 2017, time=2017-07-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=218539, encodeId=57a421853972, content=学习了新知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Tue Jul 04 15:54:46 CST 2017, time=2017-07-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=218519, encodeId=b5772185199b, content=谢谢分享,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Tue Jul 04 14:46:56 CST 2017, time=2017-07-04, status=1, ipAttribution=)]
    2017-07-04 明月清辉

    谢谢分享,学习了

    0

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