文摘
摘要目的:比较Fingolimod的表现和结果(FTY)和Natalizumab (NTZ)与渐进多焦点的脑白质病(PML)。
背景:PML JC病毒所造成的是一种严重的神经系统疾病(JCV)重新激活免疫功能不全的人。几个多发性硬化症治疗与发展中PML的风险有关。如果Natalitumab-associated PML已基本描述,数据Fingolimod-associated-PML稀缺。
设计/方法:我们进行了一项回顾性多中心队列研究在日本,德国,法国,意大利和瑞士。所有连续的病人在参与中心在2009年和2021年之间相关医源性PML Fingolimod和Natalizumab都包括在内。我们的主要结果是免疫重建炎性综合症的发生(IRIS)两组。探索变量生存和残疾(以修改规模排名-夫人)在12个月。我们也分析了这两种病因的临床和放射学表现。
结果:54例入选标准和53包含在最终的分析(10 Fingolimod组和43 Tysabri)。PML与Fingolimod发生在老年患者(中位数(iqr25 - 75): 51(41-58)和44(38-47)年,p = 0.023)和较长的治疗后持续时间((iqr25 - 75)中位数:68(44.5 - -87.42)、36(23.39 - -49.00)个月,p = 0.003)。初始PML的特点相似,除了更频繁的炎症迹象(钆增强病变iPML定义为)在Fingolimod-treated发作患者(60 vs 34.9%, p = 0.169)。尽管这些早期炎症迹象,Natalizumab-associated PML更容易发展虹膜(60%比87.2%,p = 0.07)。然而,12个月残疾(中位数(iqr25 - 75)夫人:2(2 - 3.5)和3 (2 - 4),p = 0.257)和总生存期(10%比16.3%,p = 1.000)两组相似。
结论:我们的研究表明,Fingolimod-associated PML表现出一种特殊的表示和课程,应该承认认识和治疗严重神经系统并发症。
披露:Bernard-Valnet博士没有披露。Blant女士没有披露。尼古拉德罗西已经收到个人薪酬在500 - 4999美元的范围为在科学咨询服务或数据安全监测委员会生原体。尼古拉德罗西已经收到个人薪酬在500 - 4999美元的范围为在科学咨询服务或数据安全监测委员会诺华。尼古拉德罗西已经收到个人薪酬在500 - 4999美元的范围为在科学咨询服务或数据安全监测委员会生原体。Christoph施罗德没有披露。奥德Maurousset已收到个人补偿的范围0 - 499美元为诺华公司担任顾问。奥德Maurousset已收到个人补偿的范围0 - 499美元为默克公司担任顾问。奥德Maurousset已收到个人补偿的范围0 - 499美元为科学顾问或服务数据安全监测委员会罗氏。马库斯Kraemer已收到个人补偿的范围0 - 499美元为服务Chugai演讲人。 Dr. Kume has nothing to disclose. Tatsuro Misu has nothing to disclose. Jean C. Ouallet has nothing to disclose. Maud Pallix Guyot has nothing to disclose. Dr. Gold has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biogen . Dr. Gold has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis. Dr. Gold has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Roche. Dr. Gold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genzyme. Dr. Gold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bayer Vital. Dr. Gold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eisai Pharamaceuticals. Dr. Gold has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Gold has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Gold has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for SAGE Publishers. Dr. Gold has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Novartis. Dr. Gold has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Biogen. The institution of Dr. Gold has received research support from Novartis. The institution of Dr. Gold has received research support from Biogen. Simonetta Gerevini has nothing to disclose. Dr. Ayzenberg has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Ayzenberg has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Dr. Ayzenberg has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi Aventis. Dr. Ayzenberg has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Ayzenberg has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon. Dr. Ayzenberg has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Alexion. Dr. Ayzenberg has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. Dr. Ayzenberg has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Merck. The institution of Dr. Ayzenberg has received research support from Diamed. Dr. Du Pasquier has nothing to disclose.
