% 0期刊文章%乔纳森·坎贝尔% r·布雷特麦昆%一个盖Vollmer约翰Corboy % % Nair % T新与旧的故事:长期疗效比较研究预测疾病修饰治疗Relapse-Remitting多发性硬化症(P06.196) % D J神经病学2012% % P P06.196-P06.196 % V 78% N 1补充% X目的:估计的长期疗效比较研究(CER)一线治疗glatiramer醋酸(GA), fingolimod,或natalizumab Relapse-Remitting多发性硬化症(名RRMS)。首页背景没有随机对照试验(RCT)比较所有疾病疗法(DMT)名RRMS修改。此外,相关的缺乏证据长期(> 2年)的临床结果。临床均势表明一个关键需要估计CER的证据在旧模式和新儿童发展。设计/方法:我们开发了一个仿真模型来估计平均20年比较遗传算法的有效性,fingolimod, natalizumab与名RRMS一群30岁。关键输入到模型包括发表的自然历史发展规模在扩大残疾状态(eds),从减缓疾病进展相关的治疗效果,降低复发率,渐进多焦点的风险脑白质病(PML)和效用偏好分数。输出DMT-specific长期伤害(PML)风险和收益(平均复发率和时间残疾(eds≥7))和质量调整生命年(提升)。结果:治疗期间的20年里,平均平均复发是:8.8,5.9,和4.1,平均时间(年)残疾是:18.4,18.9,19.0,GA, fingolimod, natalizumab分别。平均qaly: 11.1、11.8和12.1,分别fingolimod, natalizumab。2.9 GA相比,fingolimod导致更少的复发,残疾的空闲时间0.5年,增量0.7 qaly上涨。4.6 GA相比,natalizumab导致更少的复发,0.6年残疾的空闲时间,0.017更多的PML每治疗病人的情况下,增量1.0 qaly上涨。结论:长期的临床效益结果深受natalizumab治疗,但必须加以权衡PML的风险增加。 The QALY outcome, a composite measure that incorporates both benefits and harms, was favored by natalizumab treatment. CER models like this can be used to compare all DMTs to provide projections about long-term harms and benefits.Supported by: Funded in part by The Agency for Healthcare Research and Quality as part of the Colorado Comparative Effectiveness Research K12 Training Program: K12 HS019464.Disclosure: Dr. Campbell has received personal compensation for activities with Veritech Inc and Amgen Inc for consulting services. Dr. McQueen has nothing to disclose. Dr. Corboy has received personal compensation for activities with ProCE, Celgene Therapeutics, and Teva Neuroscience. Dr. Corboy has received personal compensation in an editorial capacity for Neurology in Clinical Practice. Dr. Corboy has received research from BioMS, Genentech, Inc., Orasi Medical, Eli Lilly & Company, Celgene Therapeutics, and Immune Tolerance Network. Dr. Vollmer has received personal compensation for activities with Teva Neuroscience, Daiichi Pharmaceutical Corporation, Eli Lilly & Company, Sanofi-Aventis Pharmaceuticals, Inc., PRIME Education, Inc., Projects in Knowledge, Guidepoint Global, Eisai Inc., Biogen Idec, Xenoport, Novartis, Schering-Plough Biopharma, Ono Pharmaceutical, Elan Corporation, Acorda, IMPAX, GlaxoSmithKline, Inc., and EMD Serono. Dr. Vollmer has recieved research support from EMD Serono, Teva Neuroscience, Novartis, Daiichi Pharmaceutical Corporation, Genzyme Corporation, Ono Pharmaceutical, Eli Lilly & Company, Sanofi-Aventis Pharmaceuticals, Inc., IMPAX, and Biogen Idec. Dr. Nair received has received personal compensation for activities with Centercor as a consultant.Thursday, April 26 2012, 07:30 am-12:00 pm %U