Aging and efficacy of disease-modifying therapies in multiple sclerosis: a meta-analysis of clinical trials.
Aging and efficacy of disease-modifying therapies in multiple sclerosis: a meta-analysis of clinical trials.
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DOI：
10.1177/1756286420969016
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发表时间：
2020
影响因子：
5.9
通讯作者：
Stuve O
中科院分区：
文献类型：
--
作者：
Zhang Y;Gonzalez Caldito N;Shirani A;Salter A;Cutter G;Culpepper W 2nd;Wallin M;Kosa P;Bielekova B;Lublin F;Stuve O
多发性硬化症（MS）的疾病修饰疗法（DMT）被批准用于治疗疾病活动，并有效减少复发和新的磁共振成像（MRI）病变。然而，疾病活动通常随时间而消退，DMT疗效的年龄依赖性变化尚未得到充分证实。我们的目的是调查年龄是否影响DMT治疗复发缓解型MS（RRMS）患者疾病活动的疗效。通过临床试验的荟萃分析评估了与年龄相关的DMT疗效，这些临床试验评估了DMT在RRMS患者中的疗效，通过年复发率（ARR）、新T2病变和MRI上钆增强病变的减少来衡量。使用每项试验的平均基线患者年龄，拟合加权线性回归，以确定年龄是否与组水平上的治疗疗效相关。荟萃分析纳入了来自14种不同DMT的26项试验的28，082例患者的组水平数据。与安慰剂组相比，年龄与ARR、新发T2病变和钆增强病变减少之间无统计学显著相关性。RRMS的DMT在治疗疾病活动性方面显示出与年龄无关的疗效，这一点已由DMT临床试验的组水平数据证明。然而，临床试验选择基线疾病活动的患者，而不考虑年龄，因此不能代表真实世界的RRMS患者，其中疾病活动随年龄下降。
Disease-modifying therapies (DMTs) for multiple sclerosis (MS) are approved for the treatment of disease activity and are effective in reducing relapses and new magnetic resonance imaging (MRI) lesions. However, disease activity generally subsides with time, and age-dependent changes in DMT efficacy are not well-established. We aimed to investigate whether age impacts the efficacy of DMTs in treating disease activity in patients with relapsing–remitting MS (RRMS). DMT efficacy related to age was assessed through a meta-analysis of clinical trials that evaluated the efficacy of DMTs in RRMS patients as measured by reductions in the annualized relapse rate (ARR), new T2 lesions, and gadolinium-enhanced lesions on MRI. Using the mean baseline patient age from each trial, a weighted linear regression was fitted to determine whether age was associated with treatment efficacy on a group level. Group-level data from a total of 28,082 patients from 26 trials of 14 different DMTs were included in the meta-analysis. There were no statistically significant associations between age and reductions in ARR, new T2 lesions, and gadolinium-enhanced lesions of the treatment group compared with placebo. DMTs for RRMS show efficacy in treating disease activity independent of age as demonstrated by group-level data from DMT clinical trials. Nevertheless, clinical trials select for patients with baseline disease activity regardless of age, thereby not representing real-world patients with RRMS, where disease activity declines with age.
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影响因子：
9.9
作者：
Lublin FD;Reingold SC;Cohen JA;Cutter GR;Sørensen PS;Thompson AJ;Wolinsky JS;Balcer LJ;Banwell B;Barkhof F;Bebo B Jr;Calabresi PA;Clanet M;Comi G;Fox RJ;Freedman MS;Goodman AD;Inglese M;Kappos L;Kieseier BC;Lincoln JA;Lubetzki C;Miller AE;Montalban X;O'Connor PW;Petkau J;Pozzilli C;Rudick RA;Sormani MP;Stüve O;Waubant E;Polman CH
通讯作者：
Polman CH
影响因子：
11.2
作者：
Hawker, Kathleen;O'Connor, Paul;Smith, Craig H.
通讯作者：
Smith, Craig H.
影响因子：
168.9
作者：
Lublin, Fred;Miller, David H.;Kappos, Ludwig
通讯作者：
Kappos, Ludwig
影响因子：
11.2
作者：
Sormani, Maria Pia;Bonzano, Laura;Bruzzi, Paolo
通讯作者：
Bruzzi, Paolo
影响因子：
6
作者：
Hutchinson, Michael;Kappos, Ludwig;Panzara, Michael A.
通讯作者：
Panzara, Michael A.