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tiancai_erbao铁杆木虫 (小有名气)
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[交流]
Laquinimod－－治疗多发性硬化的新型口服药（柳叶刀）
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Laquinimod, a new oral drug for multiple sclerosis Authors of an Article conclude that the new drug laquinimod taken orally could be an effective treatment for multiple sclerosis (MS), can reduce MRI disease activity, and is well-tolerated in patients with the relapse-remitting form of the disease. Currently available drugs for the treatment of MS are all injectable, and thus the availability of an oral agent could be an advantage in terms of convenience for patients. Relapsing-remitting multiple sclerosis is an inflammatory demyelinating disease of the CNS that is presumed to have an autoimmune cause. In most patients, the disease is chronic and progresses over decades. Early stages are heralded by relapses of neurological dysfunction within the CNS associated with transient gadolinium-enhancing lesions on T1-weighted MRI that usually leave chronic non-enhancing T1 and T2 lesions in their wake. MRI measures of disease activity have been widely adopted to screen for effectiveness of new therapies in phase I and II clinical trials, although they do not serve as the sole determinant of efficacy in phase III trials. Approved immunomodulatory drugs for relapsing-remitting multiple sclerosis are all injectable and include interferon β-1a (which is given either subcutaneously or intramuscularly), interferon β-1b and glatiramer acetate (subcutaneous), and mitoxantrone and natalizumab (intravenous). The drugs reduce the numbers of clinical relapses and new inflammatory lesions (on MRI), and decrease short-term disability to varying degrees. Many patients would prefer oral drugs, and drug com panies are seeking to provide oral treatments for multiple sclerosis with safety and efficacy that are similar to those of available treatments. In today’s Lancet, Giancarlo Comi and colleagues2 report that a new oral drug, laquinimod at 0.6 mg daily, reduces new MRI lesions in relapsing-remitting multiple sclerosis. The mean cumulative number of T1 gadolinium-enhancing lesions per MRI scan done every 4 weeks from weeks 24 to 36 was 2.6 in the treatment group compared with 4.2 in the placebo group (absolute risk reduction 1.6, relative risk reduction 40%). Secondary MRI outcomes, including cumulative number of new T2 lesions and T1 hypointense lesions, also showed benefit. |
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