医学
伊库利珠单抗
视神经脊髓炎
托珠单抗
美罗华
临床试验
硫唑嘌呤
药效学
内科学
疾病
重症监护医学
多发性硬化
免疫学
免疫系统
药代动力学
补体系统
淋巴瘤
作者
Jieren Luo,Jiesen Yu,Zichao Sui,Ying Zhong,Qingshan Zheng,Lujin Li
标识
DOI:10.1016/j.intimp.2022.109004
摘要
Neuromyelitis optica spectrum disorders (NMOSD) is an immune-mediated demyelinating disease of the central nervous system. This study aimed to perform a comprehensive comparison of the effect of seven drugs to prevent relapses of NMOSD.A literature search was conducted using public databases. Clinical studies on the seven drugs (eculizumab, inebilizumab, satralizumab, rituximab, tocilizumab, azathioprine, and mycophenolate mofetil) to prevent relapses of NMOSD were identified. A time-course model was established using the time to first relapse as the primary endpoint, in order to evaluate the long-term effect of each drug in preventing relapse.Twenty-four trials, including 2207 patients, were included in the model analysis. The results showed that monoclonal antibody therapy could significantly prolong the time to first relapse. Among all seven drugs, eculizumab can most significantly prevent patient from relapse. The estimated proportion of relapse-free patients treated with eculizumab was 98.9% at 24 months.Based on the construction of a time-course pharmacodynamic model, this study made a comprehensive quantitative comparison of seven drugs for the treatment of NMOSD for the first time. These results can not only serve as a quantitative supplement for the rational use of drugs in clinical practice but also provide a pharmacodynamic reference for clinical trial design and decision making in the future.
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