Efficacy of Brodalumab and Guselkumab in Patients with Moderate-to-Severe Plaque Psoriasis Who are Inadequate Responders to Ustekinumab: A Matching Adjusted Indirect Comparison.

IF 5.2 Q1 DERMATOLOGY Psoriasis (Auckland, N.Z.) Pub Date : 2021-11-03 eCollection Date: 2021-01-01 DOI:10.2147/PTT.S326121
Philip Hampton, Emma Borg, Jes Birger Hansen, Matthias Augustin
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引用次数: 4

Abstract

Purpose: Both brodalumab and guselkumab improve skin clearance in patients with moderate-to-severe plaque psoriasis after inadequate response to ustekinumab. In the absence of a direct head-to-head comparison, the relative efficacy of brodalumab and guselkumab in non-responders to ustekinumab were compared using a matching-adjusted indirect comparison (MAIC).

Patients and methods: Individual patient data for brodalumab (n = 121) were pooled from the AMAGINE-2 and -3 trials and adjusted using a propensity score reweighting method, so that baseline and week 16 characteristics matched the aggregate published data of patients with an inadequate response to ustekinumab who switched to guselkumab (n = 135) in the NAVIGATE trial.

Results: After inadequate response to ustekinumab, brodalumab resulted in significantly higher psoriasis area and severity index (PASI) 90 rates versus guselkumab at post-treatment switch week 12 (62.7% vs 48.1%, relative difference 14.6% [95% confidence interval [CI] 5.3-23.9], p = 0.002 [number needed to treat [NNT] = 6.8]) and week 36 (63.7% vs 51.1%; relative difference 12.6% [95% CI 4.1-21.0]; p = 0.004 [NNT = 7.9]) and PASI 100 rate at week 36 (40.3% vs 20.0%; relative difference 20.3% [95% CI 11.8-28.7]; p < 0.001 [NNT = 4.9]).

Conclusion: In this MAIC, brodalumab was associated with greater improvements than guselkumab in inadequate responders to ustekinumab. Switching to brodalumab in such patients may be a more effective strategy than switching to guselkumab.

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Brodalumab和Guselkumab对Ustekinumab反应不足的中重度斑块型银屑病患者的疗效:匹配调整的间接比较。
目的:brodalumab和guselkumab均可改善对ustekinumab反应不足的中重度斑块性银屑病患者的皮肤清除率。在没有直接头对头比较的情况下,使用匹配调整间接比较(MAIC)比较了对ustekinumab无反应的brodalumab和guselkumab的相对疗效。患者和方法:从AMAGINE-2和-3试验中收集brodalumab的个体患者数据(n = 121),并使用倾向评分重新加权法进行调整,以便基线和第16周特征与在NAVIGATE试验中对ustekinumab反应不足转而使用guselkumab的患者(n = 135)的总体已发表数据相匹配。结果:在对ustekinumab反应不足后,在治疗后切换第12周,brodalumab导致银屑病面积和严重程度指数(PASI) 90率显著高于guselkumab (62.7% vs 48.1%,相对差异14.6%[95%置信区间[CI] 5.3-23.9], p = 0.002[所需治疗人数[NNT] = 6.8])和第36周(63.7% vs 51.1%;相对差异12.6% [95% CI 4.1 ~ 21.0];p = 0.004 [NNT = 7.9])和第36周PASI 100率(40.3% vs 20.0%;相对差异20.3% [95% CI 11.8-28.7];p < 0.001 [NNT = 4.9])。结论:在这项MAIC中,在对ustekinumab反应不足的患者中,brodalumab比guselkumab有更大的改善。在这类患者中,改用brodalumab可能比改用guselkumab更有效。
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