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Tác động của việc sử dụng metformin lên kết quả của bệnh nhân đa xơ cứng tái phát - thuyên giảm nhận interferon beta 1a: một thử nghiệm ngẫu nhiên có kiểm soát giai đoạn II mở
Deutsche Zeitschrift für Nervenheilkunde - Trang 1-9 - 2023
Tóm tắt
Bệnh đa xơ cứng (MS) là một rối loạn thoái hóa thần kinh mãn tính do thiếu myelin. Mức độ chất trung gian viêm pro-inflammatory và một số tham số stress oxy hóa cao có thể thúc đẩy quá trình mất myelin. Chúng tôi nhằm mục đích nghiên cứu hiệu quả và độ an toàn của metformin như một liệu pháp bổ trợ cho interferon beta 1a (IFNβ-1a) ở bệnh nhân đa xơ cứng tái phát - thuyên giảm (RRMS). Tám mươi bệnh nhân RRMS được chia đều thành 2 nhóm: Nhóm can thiệp nhận IFNβ-1a cộng với 2 g metformin mỗi ngày một lần và nhóm đối chứng chỉ nhận IFNβ-1a. Interleukin 17 (IL17), interleukin 22 (IL22), malondialdehyde (MDA), tổn thương T2 trong chụp cộng hưởng từ (MRI) và thang trạng thái khuyết tật mở rộng (EDSS) được đánh giá tại thời điểm bắt đầu và sau 6 tháng. Tại thời điểm bắt đầu, không có sự khác biệt có ý nghĩa thống kê giữa hai nhóm (p > 0,05). Sau 6 tháng, sự thay đổi trong trung vị (khoảng tứ phân) của các kết quả cho cả nhóm can thiệp và nhóm đối chứng là; IL17 (−1,39 (4,19) so với −0,93 (5,48), p = 0,48), IL22 (−0,14 (0,48) so với −0,09 (0,6), p = 0,53), và EDSS (0 so với 0, p = 1), tương ứng. Sự thay đổi trung bình (độ lệch chuẩn) trong MDA cho nhóm can thiệp và nhóm đối chứng lần lượt là − 0,93 (2,2) so với −0,5 (2,53), p = 0,038. Đối với kết quả MRI, 21 bệnh nhân có thể đứng yên và thuyên giảm và 1 bệnh nhân có diễn biến tiến triển trong nhóm can thiệp so với 12 bệnh nhân có thể đứng yên và thuyên giảm và 4 bệnh nhân có tiến triển trong nhóm đối chứng, p = 0,14. Việc thêm metformin vào IFNβ-1a cho thấy một hiệu ứng tiềm năng trên một chỉ số stress oxy hóa (MDA). Tuy nhiên, không có hiệu ứng có ý nghĩa thống kê lên các kết quả miễn dịch học, MRI và lâm sàng. Chúng tôi khuyến nghị các nghiên cứu quy mô lớn hơn để xác nhận hoặc bác bỏ những phát hiện này. Số đăng ký ClinicalTrials.gov: NCT05298670, 28/3/2022.
Từ khóa
#đa xơ cứng #metformin #interferon beta 1a #liệu pháp bổ trợ #thử nghiệm lâm sàngTài liệu tham khảo
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