在多发性硬化症患者中,福必定治疗效果的可变性是什么

Klára Novotná, J. Preiningerova, L. Sobíšek, E. Havrdová
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引用次数: 1

摘要

背景:步态障碍是多发性硬化(MS)最常见的症状之一。福必定是第一个旨在改善步态的对症治疗。一个客观的测量从治疗开始的活动能力改善已被推荐用于评估治疗反应。目的:在这项回顾性观察性研究中,我们评估了在临床实践中使用福普定治疗多发性硬化症(MS)患者在特定残疾水平(EDSS 4.0-7.0)方面的步行速度改善。方法:在给药前和给药后3 h进行运动能力测试,包括定时25英尺步行测试(T25FW)、定时起身和行走测试(TUG)和步速测试(ST)。131例MS患者(15例为原发性进展,40例为继发性进展,76例为复发缓解型MS)。平均年龄48岁(SD 9.8), MS平均病程19.8年,女性占58%。用T25FW试验测量的福普定治疗反应范围为11-41%。与先前的报道相反,基线T25FW与T25FW改善百分比显着相关。结论:与RCT相比,临床试验之外的治疗反应评估具有挑战性,可能需要不同的结果测量。对于中度残疾的MS患者,TUG试验或Step试验似乎更适合用于量化治疗反应。
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What Variability of Treatment Effect of Fampridine Can We Expect in People with Multiple Sclerosis
Background: Gait impairment represents one of the most common symptoms of multiple sclerosis (MS). Fampridine is the first symptomatic treatment aimed at improving gait. An objective measurement of the mobility improvement from treatment initiation has been recommended to evaluate treatment response. Objective: In this retrospective observational study, we evaluated what improvement in walking speed can be expected in people with multiple sclerosis (MS) treated with Fampridine in clinical practice, with respect to specific disability levels (EDSS 4.0-7.0). Methods: The mobility tests including the Timed 25 foot walk test (T25FW), Timed Up and Go test (TUG) and Step test (ST) were performed just before and 3 h after administration of Fampridine 10 mg tablet. Results: One hundred and thirty one (131) people with MS (15 with primary progressive, 40 with secondary progressive and 76 people with relapsing-remitting MS). The mean age was 48 years (SD 9.8), mean MS duration was 19, 8 years, 58% were women. The range of treatment response of Fampridine, measured with the T25FW test, varied from 11-41%. Contrary to prior reports, the baseline T25FW and the percentage of improvement in T25FW was significantly correlated. Conclusion: Assessment of treatment response outside of a clinical trial is challenging and may require different outcome measures compared to RCT. For MS patients with moderate disability seems TUG test or Step test more appropriate for quantifying treatment response.
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