AIM:To investigate the short-term efficacy and safety of inebilizumab for neuromyelitis optica spectrum disorders(NMOSD).METHODS:A total of 33 patients with NMOSD treated with inebilizumab(Group INB,n=15)or rituximab(...AIM:To investigate the short-term efficacy and safety of inebilizumab for neuromyelitis optica spectrum disorders(NMOSD).METHODS:A total of 33 patients with NMOSD treated with inebilizumab(Group INB,n=15)or rituximab(Group RTX,n=18)in addition to high-dose glucocorticoids were included.Both groups underwent hormone shock therapy during the acute phase.Subsequently,Group INB received inebilizumab injections during the remission phase,while Group RTX received rituximab injections.A comparison of aquaporins 4(AQP4)titer values,peripheral blood B lymphocyte counts,and visual function recovery was conducted before and 8wk after treatment.Additionally,adverse reactions and patient tolerability were analyzed after using inebilizumab treatment regimes.RESULTS:Following inebilizumab treatment,there was a significantly improvement in the visual acuity of NMOSD patients(P<0.05),accompanied by a notable decrease in AQP4 titer values and B lymphocyte ratio(P<0.05).Moreover,inebilizumab treatment showed a partial effect in preventing optic nerve atrophy(P<0.05).However,there were no significant differences in other therapeutic effects compared to rituximab,which has previously demonstrated substantial therapeutic efficacy(P>0.05).Furthermore,inebilizumab exhibited higher safety levels than that of rituximab injections.CONCLUSION:The combination of inebilizumab and high-dose glucocorticoids proves to be effective.In comparison to rituximab injections,inebilizumab displays better tolerance and safety.Moreover,it demonstrates a partial effect in preventing optic nerve atrophy.Thus,it stands as an effective method to reduce the disability rates and improve the daily living ability of patients with NMOSD.展开更多
Background The global spread of coronavirus disease 2019(COVID-19)continues to threaten human health security,exerting considerable pressure on healthcare systems worldwide.While prognostic models for COVID-19 hospita...Background The global spread of coronavirus disease 2019(COVID-19)continues to threaten human health security,exerting considerable pressure on healthcare systems worldwide.While prognostic models for COVID-19 hospitalized or intensive care patients are currently available,prognostic models developed for large cohorts of thousands of individuals are still lacking.Methods Between February 4 and April 16,2020,we enrolled 3,974 patients admitted with COVID-19 disease in the Wuhan Huo-Shen-Shan Hospital and the Maternal and Child Hospital,Hubei Province,China.(1)Screening of key prognostic factors:A univariate Cox regression analysis was performed on 2,649 patients in the training set,and factors affecting prognosis were initially screened.Subsequently,a random survival forest model was established through machine analysis to further screen for factors that are important for prognosis.Finally,multivariate Cox regression analysis was used to determine the synergy among various factors related to prognosis.(2)Establishment of a scoring system:The nomogram algorithm established a COVID-19 patient death risk assessment scoring system for the nine selected key prognostic factors,calculated the C index,drew calibration curves and drew training set patient survival curves.(3)Verification of the scoring system:The scoring system assessed 1,325 patients in the test set,splitting them into high-and low-risk groups,calculated the C-index,and drew calibration and survival curves.Results The cross-sectional study found that age,clinical classification,sex,pulmonary insufficiency,hypoproteinemia,and four other factors(underlying diseases:blood diseases,malignant tumor;complications:digestive tract bleeding,heart dysfunction)have important significance for the prognosis of the enrolled patients with COVID-19.Herein,we report the discovery of the effects of hypoproteinemia and hematological diseases on the prognosis of COVID-19.Meanwhile,the scoring system established here can effectively evaluate objective scores for the early prognoses of patients with COVID-19 and can divide them into high-and low-risk groups(using a scoring threshold of 117.77,a score below which is considered low risk).The efficacy of the system was better than that of clinical classification using the current COVID-19 guidelines(C indexes,0.95 vs.0.89).Conclusions Age,clinical typing,sex,pulmonary insufficiency,hypoproteinemia,and four other factors were important for COVID-19 survival.Compared with general statistical methods,this method can quickly and accurately screen out the relevant factors affecting prognosis,provide an order of importance,and establish a scoring system based on the nomogram model,which is of great clinical significance.展开更多
文摘AIM:To investigate the short-term efficacy and safety of inebilizumab for neuromyelitis optica spectrum disorders(NMOSD).METHODS:A total of 33 patients with NMOSD treated with inebilizumab(Group INB,n=15)or rituximab(Group RTX,n=18)in addition to high-dose glucocorticoids were included.Both groups underwent hormone shock therapy during the acute phase.Subsequently,Group INB received inebilizumab injections during the remission phase,while Group RTX received rituximab injections.A comparison of aquaporins 4(AQP4)titer values,peripheral blood B lymphocyte counts,and visual function recovery was conducted before and 8wk after treatment.Additionally,adverse reactions and patient tolerability were analyzed after using inebilizumab treatment regimes.RESULTS:Following inebilizumab treatment,there was a significantly improvement in the visual acuity of NMOSD patients(P<0.05),accompanied by a notable decrease in AQP4 titer values and B lymphocyte ratio(P<0.05).Moreover,inebilizumab treatment showed a partial effect in preventing optic nerve atrophy(P<0.05).However,there were no significant differences in other therapeutic effects compared to rituximab,which has previously demonstrated substantial therapeutic efficacy(P>0.05).Furthermore,inebilizumab exhibited higher safety levels than that of rituximab injections.CONCLUSION:The combination of inebilizumab and high-dose glucocorticoids proves to be effective.In comparison to rituximab injections,inebilizumab displays better tolerance and safety.Moreover,it demonstrates a partial effect in preventing optic nerve atrophy.Thus,it stands as an effective method to reduce the disability rates and improve the daily living ability of patients with NMOSD.
基金supported by National Key Research and Development Program of China(2020YFC2002706).
文摘Background The global spread of coronavirus disease 2019(COVID-19)continues to threaten human health security,exerting considerable pressure on healthcare systems worldwide.While prognostic models for COVID-19 hospitalized or intensive care patients are currently available,prognostic models developed for large cohorts of thousands of individuals are still lacking.Methods Between February 4 and April 16,2020,we enrolled 3,974 patients admitted with COVID-19 disease in the Wuhan Huo-Shen-Shan Hospital and the Maternal and Child Hospital,Hubei Province,China.(1)Screening of key prognostic factors:A univariate Cox regression analysis was performed on 2,649 patients in the training set,and factors affecting prognosis were initially screened.Subsequently,a random survival forest model was established through machine analysis to further screen for factors that are important for prognosis.Finally,multivariate Cox regression analysis was used to determine the synergy among various factors related to prognosis.(2)Establishment of a scoring system:The nomogram algorithm established a COVID-19 patient death risk assessment scoring system for the nine selected key prognostic factors,calculated the C index,drew calibration curves and drew training set patient survival curves.(3)Verification of the scoring system:The scoring system assessed 1,325 patients in the test set,splitting them into high-and low-risk groups,calculated the C-index,and drew calibration and survival curves.Results The cross-sectional study found that age,clinical classification,sex,pulmonary insufficiency,hypoproteinemia,and four other factors(underlying diseases:blood diseases,malignant tumor;complications:digestive tract bleeding,heart dysfunction)have important significance for the prognosis of the enrolled patients with COVID-19.Herein,we report the discovery of the effects of hypoproteinemia and hematological diseases on the prognosis of COVID-19.Meanwhile,the scoring system established here can effectively evaluate objective scores for the early prognoses of patients with COVID-19 and can divide them into high-and low-risk groups(using a scoring threshold of 117.77,a score below which is considered low risk).The efficacy of the system was better than that of clinical classification using the current COVID-19 guidelines(C indexes,0.95 vs.0.89).Conclusions Age,clinical typing,sex,pulmonary insufficiency,hypoproteinemia,and four other factors were important for COVID-19 survival.Compared with general statistical methods,this method can quickly and accurately screen out the relevant factors affecting prognosis,provide an order of importance,and establish a scoring system based on the nomogram model,which is of great clinical significance.
