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相對風險降低對於評估多發性硬化症疾病修飾療法的益處的價值有限

馬格德·扎卡里亞

相對風險降低（RRR）是用於傳達臨床藥物初步的獨特基本結果的基本可測量邊界。醫生經常期望在一項初步試驗中顯示的具有較高RRR 的藥物比在另一項初步試驗中顯示的具有較低RRR 的藥物更有吸引力，並且可能會將這一計劃提供給更多年輕的醫生和患者。將 RRR 用作藥物充足性的一部分可能會產生誤導，因為它依賴於公眾的想法。 RRR 的估計取決於假治療事件率：如果假治療組中的事件率較高，則低 RRR 可能具有臨床意義，而如果假治療組中的事件率高，則 RRR 可能在臨床上不太重要。是低的。直接無限制的相關初步研究是調查各種藥物整體可行性的最佳方法。本介紹的目的是解決這種混亂。

多發性硬化症 (MS) 是一種以局部感覺系統 (CNS) 惡化、脫髓鞘和變性為特徵的疾病。混亂的跡像是在感染過程中立即發生的神經系統表現的倒退和減輕，這通常與中樞神經系統惡化和髓鞘喪失有關。這種刺激的誘發原因尚不清楚，但被認為是多因素的，生態和遺傳影響導致T 細胞介導的免疫系統對中樞神經系統產生多種反應。可能會更頻繁地發生並被描述為軸突變體和暗物質衰退，被認為是由於天然安全框架的直接細胞毒性運動以及有害中間體（例如一氧化氮）造成的。儘管在適當的時候會出現不同的侮辱，但隨著時間的推移，神經系統障礙通常會變得越來越明顯。無力極限假說認為，神經功能可以彌補腦部組織的缺陷，直到超過累積損傷的邊緣。

The frequency of MS follows a geographic slope; rates ascend as the good ways from the equator increases. This is believed to be because of the angle of relative sun introduction and its job in the creation of nutrient D, which assumes a significant job in safe guideline when changed over to its dynamic hormonal structure. Numerous sclerosis is more common in non-Hispanic white patients than it is in other racial gatherings, and ladies are influenced almost 2 to multiple times more regularly than are men. About 450,000 people in the U.S. furthermore, in excess of 2 million worldwide have MS.

Numerous sclerosis is the most widely recognized reason for nontraumatic neurologic inability in youthful grown-ups. It is commonly analyzed in the third and fourth many years of life, and the individuals who are analyzed after age 50 years regularly can relate neurologic indications that started a long time previously. Be that as it may, pediatric-beginning and new-beginning cases in the old have been accounted for. It has been assessed that up to 10% of patients with MS have beginning before 18 years of age. Compared with grown-up beginning MS, pediatric-beginning is related with a more drawn out period between introductory assault and physical incapacity, in spite of the fact that the normal time of handicap beginning is around 10 years more youthful

The objective of MS sickness altering treatment is to lessen the early clinical and subclinical malady action that in the long run adds to long haul disability. There are as of now 13 FDA-affirmed infection adjusting treatments for MS. These incorporate 7 self-infusing treatments, 3 oral treatments, and 3 implantation treatments. These 13 drugs have 8 unique instruments of activity (MOA) that target particular zones of the resistant intervened ailment process. They likewise vary in their frequencies and courses of organization notwithstanding their unfavorable impact (AE) profiles

Different sclerosis stays a profoundly unusual infection, and backslides can deliver a quantifiable and supported effect fair and square of disability. Still, the impact of decreased backslides on forestalling incapacity in an individual patient stays indistinct. Huge, long haul, planned associate investigations may explain whether early treatment influences sickness movement and disability. However, it is very clear that viable backslide decrease diminishes uneasiness, lessens days lost from work and other significant exercises of day by day life, and improves QOL.

關於這種獨特的感染，還有很多東西需要了解，但臨床寫作中的證據表明，定義治療目標具有重要意義，其中包括專注於疾病運動以實現早期和成功的控制。眾所周知，使用多發性硬化症藥物實現控制是緩解可能出現的身體和情感障礙的關鍵部分，幫助患者保持活力並盡可能保持最顯著的生活品質。