皮质类固醇、布洛芬及扑热息痛治疗多发性硬化症的IFNβ-1a类流感综合征:随机试验  

Corticosteroids, ibuprofen, and acetamino phen for IFNβ-1a flu symptoms in MS: A randomized trial

作　　者：Ro J. Nos C. Bonaventura I. 高方 

机构地区：[1]2 planta EUI, Unitat de Neuroimmunologia Clinica, Hospital Universitario Vall d’Hebron, Psg. Vall d’Hebron 119- 120, 08035 Barcelona, Spain Dr.

出　　处：《世界核心医学期刊文摘（神经病学分册）》2005年第1期54-55,共2页Digest of the World Core Medical Journals:Clinical Neurology

摘　　要：Objective: To compare the efficacy of acetaminophen, ibuprofen, and prednisone in the treatment of interferon β-1a (IFNβ-1a) flu like syndrome (FLS). Methods: Patients with relapsing remitting multiple sclerosis initiating treatment with IM IFNβ 1a were randomized in a multicenter, randomized, double blind, controlled trial to receive acetaminophen 500 mg before and 6 and 12 hours after each injection, ibuprofen 400 mg before and 6 and 12 hours after each injection, or prednisone 60 mg daily for 1 week, plus tapering. Patients were instructed to keep a daily diary of fever severity, myalgia, chills, headache, and asthenia for 27 days. The sum of the scores of individual symptoms was used to obtain a daily FLS index. The primary outcome was the FLS index area under the curve (AUC) corrected by the number of measurement days. Results: Eighty four patients were randomized at 11 hospitals: acetaminophen (n = 28), ibuprofen (n = 28), and corticosteroids (n = 28). No differences were detected between treatments in the mean AUC of the FLS index. With limitation of the analysis to the days of IM IFNβ 1a injection, differences favoring ibuprofen were observed in the mean FLS index (p = 0.0007). Conclusions: No prophylactic treatment for flu like syndrome seems to be superior to another in terms of overall well being during the first month of IM IFNβ 1a therapy. However, ibuprofen confers better control of symptoms immediately following IM IFNβ 1a injection.Objective: To compare the efficacy of acetaminophen, ibuprofen, and prednisone in the treatment of interferon β-1a (IFNβ-1a) flu like syndrome (FLS). Methods: Patients with relapsing remitting multiple sclerosis initiating treatment with IM IFNβ 1a were randomized in a multicenter, randomized, double blind, controlled trial to receive acetaminophen 500 mg before and 6 and 12 hours after each injection, ibuprofen 400 mg before and 6 and 12 hours after each injection, or prednisone 60 mg daily for 1 week, plus tapering. Patients were instructed to keep a daily diary of fever severity, myalgia, chills, headache, and asthenia for 27 days. The sum of the scores of individual symptoms was used to obtain a daily FLS index. The primary outcome was the FLS index area under the curve (AUC) corrected by the number of measurement days. Results: Eighty four patients were randomized at 11 hospitals: acetaminophen (n = 28), ibuprofen (n = 28), and corticosteroids (n = 28). No differences were detected between treatments in the mean AUC of the FLS index. With limitation of the analysis to the days of IM IFNβ 1a injection, differences favoring ibuprofen were observed in the mean FLS index (p = 0.0007). Conclusions: No prophylactic treatment for flu like syndrome seems to be superior to another in terms of overall well being during the first month of IM IFNβ 1a therapy. However, ibuprofen confers better control of symptoms immediately following IM IFNβ 1a injection.

关 键 词：多发性硬化症 IFN 皮质类固醇 流感综合征 扑热息痛 随机试验 发热程度 肌肉注射 肌痛 整体健康状况 

分 类 号：R744.51[医药卫生—神经病学与精神病学]