MS-assoziierte Fatigue – Welche Immuntherapie hilft?

Zusammenfassung

Hintergrund: Fatigue ist bei Patienten mit Multiple Sklerose ein häufiges Symptom mit maßgeblichem Einfluss auf die Lebensqualität der Erkrankten. Durch Immuntherapien kann der Krankheitsverlauf der Multiple Sklerose günstig beeinflusst werden, insbesondere die Schubfrequenz. Wenig untersucht ist dagegen die Wirksamkeit der verschiedenen Immuntherapien auf MS-assoziierte Fatigue.

Ziel der Arbeit: In der vorliegenden Übersicht stellen wir für alle derzeit zugelassenen Immuntherapeutika ausführlich dar, welche Daten zu deren Fatigue-Wirksamkeit vorliegen. Anschließend werden die Ergebnisse zusammengefasst, diskutiert und es werden Hinweise gegeben, wie diese Studienergebnisse in die klinische Praxis einfließen können.

Ergebnis: Nur für Teriflunomid liegen Daten aus mehreren randomisierten, kontrollierten Studien vor; die Ergebnisse sind negativ. Ein fehlender oder allenfalls marginaler Effekt auf das Fatigue-Erleben der MS-Patienten ist auch für die Gruppe der Beta-Interferone anzunehmen. Für Glatirameracetat, Fingolimod und Natalizumab liegen positive Studienresultate vor. Der Evidenzgrad ist jedoch gering und weitere Studien sind dringend erforderlich. Für alle übrigen Substanzen liegen derzeit keine ausreichenden Daten vor.

Abstract

Fatigue is one of the most common symptoms of multiple sclerosis (MS) and has a negative effect on quality of life. Therefore, the potential impact of disease-modifying drugs (DMDs) on fatigue is receiving increasing attention. This review article summarizes the current data on the potential impact of DMDs on fatigue in MS. To date, this issue has not been directly addressed by controlled studies. While interferon-beta and teriflunomide have been reported to be at best moderately effective, the use of natalizumab, glatiramer acetate or fingolimod has shown positive influence on fatigue. No data are available on the efficacy of other DMDs on fatigue. Further randomized trials are urgently needed.

Schlüsselwörter

Multiple Sklerose - Fatigue - Immuntherapie - Übersicht

Keywords

multiple sclerosis - fatigue - review - disease-modifying therapy

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