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首页> 外文期刊>Journal of neurology >Peginterferon beta-1a reduces the evolution of MRI lesions to black holes in patients with RRMS: a post hoc analysis from the ADVANCE study
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Peginterferon beta-1a reduces the evolution of MRI lesions to black holes in patients with RRMS: a post hoc analysis from the ADVANCE study

机译：Peginterferonβ-1a减少了RRMS患者的MRI病变对黑洞的演变：来自先进研究的后HOC分析

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The presence of chronic black holes, i.e., chronic lesions that are hypointense on T1-weighted images and are indicative of more severe tissue injury, has been increasingly utilized as a surrogate marker of therapeutic outcome in multiple sclerosis. The ADVANCE study was a 2-year, double-blind, pivotal trial evaluating the safety and efficacy of subcutaneous peginterferon beta-1a 125 mcg in 1512 patients with relapsing-remitting multiple sclerosis (RRMS). This report describes the correlation of clinical outcomes with the evolution of acute lesions into chronic black holes in ADVANCE, and the efficacy of peginterferon beta-1a in reducing this evolution. Treatment with peginterferon beta-1a significantly reduced the mean number of new/enlarging T2-weighted (NET2) lesions (0.76 vs. 1.03 from week 24, p = 0.0037; 0.44 vs. 0.99 from week 48, p < 0.0001) and new gadolinium-enhancing (Gd+) lesions (0.15 vs. 0.32 from week 24, p < 0.0001; 0.09 vs. 0.19 from week 48) that evolved into chronic black holes by 2 years. Patients with NET2 or Gd+ lesions at 24 weeks that evolved into chronic black holes showed significantly worse clinical outcomes, including a greater proportion with 12-week (14.9 vs. 8.4%; p = 0.0167) and 24-week (12.3 vs. 7.0%; p = 0.0333) confirmed disability worsening and higher mean annualized relapse rate (0.62 vs. 0.43; p = 0.0118), compared with patients with lesions that did not evolve into black holes. The correlation was independent of treatment. Reduced risk of evolution of new lesions into chronic black holes with peginterferon beta-1a treatment suggests potential to reduce long-term disability in RRMS by preventing irreversible tissue damage.
机译：慢性黑孔的存在，即对T1加权图像的低迷的慢性病变，表明更严重的组织损伤，越来越多地用于多发性硬化症中治疗结果的替代标志物。预先研究是2年，双盲，关键试验，评估皮下Peginterferens Beta-1a 125mcg在1512例复发延迟多发性硬化症（RRMS）患者中的安全性和有效性。本报告描述了临床结果与急性病变进入慢性黑洞的慢性黑洞的相关性，以及Peginterferonβ-1a在减少这种进化中的功效。用Peg选项蛋白β-1a处理显着降低了新/扩大T2加权（NET2）病变的平均数量（从第24周，P = 0.0037，0.44与0.44与0.44与0.44 vs.0.99来自周48，P <0.0001）和新的钆-Nenvancing（Gd +）病变（0.15与周22.30，P <0.01; 0.09与0.09与0.09与0.19），从2年内进化到慢性黑洞。在24周的24周内患有Net2或Gd +病变的患者显示出显着较差的临床结果，包括12周（14.9与8.4％; p = 0.0167）和24周（12.3与7.0％）的更大比例; P = 0.0333）证实残疾恶化和较高的年化复发率（0.62 vs.0.43; p = 0.0118），与病变没有进化到黑洞的病变。相关性与治疗无关。降低新病变进化到慢性黑洞的慢性黑洞，通过防止不可逆的组织损伤，促使RRMS中的长期残疾。

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