Effectiveness of autologous haematopoietic stem cell transplantation versus natalizumab in progressive multiple sclerosis

纳塔利祖玛 医学 扩大残疾状况量表 多发性硬化 移植 造血干细胞移植 内科学 免疫学
作者
Tomáš Kalinčík,Sifat Sharmin,Izanne Roos,Jennifer Massey,Ian Sutton,Barbara Withers,Mark S. Freedman,Harold Atkins,Eva Krasulová,Eva Havrdová,Marek Trněný,Tomáš Kozák,Joachim Burman,Richard Macdonell,Øivind Torkildsen,Lars Bö,Anne Kristine Lehmann,Basil Sharrack,John A. Snowden
出处
期刊:Journal of Neurology, Neurosurgery, and Psychiatry [BMJ]
卷期号:95 (8): 775-783 被引量:2
标识
DOI:10.1136/jnnp-2023-332790
摘要

Background Natalizumab was not shown to modify disability in progressive multiple sclerosis (MS). This matched observational study compared the effectiveness of autologous haematopoietic stem cell transplantation (AHSCT) with natalizumab in progressive MS. Methods Patients with primary/secondary progressive MS from seven AHSCT MS centres and the MSBase registry, treated with AHSCT or natalizumab, were matched on a propensity score derived from sex, age, Expanded Disability Status Scale (EDSS), number of relapses 12/24 months before baseline, time from MS onset, the most effective prior therapy and country. The pairwise-censored groups were compared on hazards of 6-month confirmed EDSS worsening and improvement, relapses and annualised relapse rates (ARRs), using Andersen-Gill proportional hazards models and conditional negative binomial model. Results 39 patients treated with AHSCT (37 with secondary progressive MS, mean age 37 years, EDSS 5.7, 28% with recent disability progression, ARR 0.54 during the preceding year) were matched with 65 patients treated with natalizumab. The study found no evidence for difference in hazards of confirmed EDSS worsening (HR 1.49, 95% CI 0.70 to 3.14) and improvement (HR 1.50, 95% CI 0.22 to 10.29) between AHSCT and natalizumab over up to 4 years. The relapse activity was also similar while treated with AHSCT and natalizumab (ARR: mean±SD 0.08±0.28 vs 0.08±0.25; HR 1.05, 95% CI 0.39 to 2.82). In the AHSCT group, 3 patients experienced febrile neutropenia during mobilisation, 9 patients experienced serum sickness, 6 patients required intensive care unit admission and 36 patients experienced complications after discharge. No treatment-related deaths were reported. Conclusion This study does not support the use of AHSCT to control disability in progressive MS with advanced disability and low relapse activity.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
大幅提高文件上传限制,最高150M (2024-4-1)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
cc完成签到,获得积分10
刚刚
隐形曼青应助xudonghui采纳,获得10
1秒前
深情安青应助水杯不离手采纳,获得10
2秒前
悠然完成签到,获得积分10
4秒前
phoenix完成签到,获得积分0
4秒前
迷人的叫兽完成签到,获得积分10
4秒前
科目三应助默默的金针菇采纳,获得10
4秒前
6秒前
6秒前
科目三应助白三烯采纳,获得10
6秒前
CodeCraft应助关七采纳,获得10
6秒前
小石头完成签到,获得积分10
7秒前
7秒前
8秒前
9秒前
充电宝应助符fu采纳,获得10
9秒前
BK1BK22发布了新的文献求助10
9秒前
悠然发布了新的文献求助10
10秒前
脑洞疼应助小C采纳,获得30
11秒前
深情安青应助esyncoms采纳,获得10
11秒前
打打应助小尾巴采纳,获得10
11秒前
张童鞋完成签到 ,获得积分10
12秒前
飘逸灵珊发布了新的文献求助10
12秒前
yun发布了新的文献求助10
12秒前
12秒前
13秒前
YORLAN完成签到 ,获得积分10
13秒前
小镇的废物完成签到,获得积分10
14秒前
15秒前
xudonghui发布了新的文献求助10
15秒前
17秒前
哈哈哈哈发布了新的文献求助10
19秒前
19秒前
情怀应助RRRosie采纳,获得10
20秒前
22秒前
JMao发布了新的文献求助30
22秒前
24秒前
24秒前
Oliver发布了新的文献求助10
24秒前
25秒前
高分求助中
Sustainability in Tides Chemistry 2800
The Young builders of New china : the visit of the delegation of the WFDY to the Chinese People's Republic 1000
Rechtsphilosophie 1000
Bayesian Models of Cognition:Reverse Engineering the Mind 888
Le dégorgement réflexe des Acridiens 800
Defense against predation 800
Very-high-order BVD Schemes Using β-variable THINC Method 568
热门求助领域 (近24小时)
化学 医学 生物 材料科学 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 基因 遗传学 催化作用 物理化学 免疫学 量子力学 细胞生物学
热门帖子
关注 科研通微信公众号,转发送积分 3136060
求助须知:如何正确求助?哪些是违规求助? 2786881
关于积分的说明 7779829
捐赠科研通 2443052
什么是DOI,文献DOI怎么找? 1298859
科研通“疑难数据库(出版商)”最低求助积分说明 625232
版权声明 600870