冷凝集素病患者长期使用苏替米单抗后患者报告结果的持续改善:CADENZA 研究开放标签扩展的结果。

IF 9.6 1区 医学 Q1 MEDICINE, GENERAL & INTERNAL EClinicalMedicine Pub Date : 2024-07-18 eCollection Date: 2024-08-01 DOI:10.1016/j.eclinm.2024.102732
Alexander Röth, Catherine M Broome, Wilma Barcellini, Bernd Jilma, Quentin A Hill, David Cella, Tor Henrik Anderson Tvedt, Masaki Yamaguchi, Irina Murakhovskaya, Michelle Lee, Frank Shafer, Marek Wardęcki, Deepthi Jayawardene, Ronnie Yoo, Jerome Msihid, Ilene C Weitz
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引用次数: 0

摘要

背景:冷凝集素病(Cold agglutinin disease,CAD)是一种罕见的自身免疫性溶血性贫血亚型,其特点是典型的补体途径介导的溶血、疲劳和生活质量(QoL)低下。在两项三期试验(CARDINAL 和 CADENZA)中,C1s 抑制剂 Sutimlimab 迅速阻止了溶血,并改善了 CAD 患者的患者报告结果(PROs)。在此,我们将报告 CADENZA 开放标签扩展试验(B 部分)的疗效:第一位患者于 2018 年 3 月加入 CADENZA(NCT03347422)(A 部分),最后一位患者于 2021 年 12 月完成研究(B 部分)。所有完成为期26周A部分的患者均有资格在B部分中接受每两周一次的苏替米单抗治疗,直至最后一名患者完成A部分治疗后的1年:共有 32/39 名患者完成了 B 部分治疗;B 部分治疗时间的中位数为 99 周。在 B 部分从安慰剂转为使用 sutimlimab 的患者,其慢性疾病治疗功能评估(FACIT)-疲劳评分和其他 PROs 均迅速改善。在整个 B 部分中,转用苏替米单抗和继续接受苏替米单抗治疗的患者的 FACIT-疲劳评分均出现了持续的、具有重要临床意义的改善(LV 期与基线相比的合并组平均值[SE]变化:8.8 [2.1])。同样,12项简表健康调查身体(4.9 [1.7])和精神(4.0 [1.8])部分得分的合并组平均[SE]变化超过了LV时与基线相比的临床重要变化。EuroQol视觉模拟量表显示,在接受苏替莫单抗治疗后,与基线相比有一致且持续的增长。经过9周的冲洗后,所有PRO指标均接近基线值:释义:使用sutimlimab继续抑制经典补体途径可使CAD患者的PROs(疲劳和QoL)得到有意义的长期改善:资金来源:赛诺菲
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Sustained improvements in patient-reported outcomes after long-term sutimlimab in patients with cold agglutinin disease: results from the CADENZA study open-label extension.

Background: Cold agglutinin disease (CAD) is a rare subtype of autoimmune haemolytic anaemia characterised by classical complement pathway-mediated haemolysis, fatigue, and poor quality of life (QoL). Sutimlimab, a C1s inhibitor, rapidly halted haemolysis, and improved patient-reported outcomes (PROs) in patients with CAD in two phase 3 trials (CARDINAL and CADENZA). Here we report PROs from the CADENZA open-label extension (Part B).

Methods: The first patient was enrolled in CADENZA (NCT03347422) in March 2018 (Part A) and the last patient completed the study in December 2021 (Part B). All patients who completed the 26-week Part A were eligible to receive biweekly doses of sutimlimab in Part B for up to 1 year after the last patient completed Part A. PROs were assessed throughout Part B, until the last on-treatment visit with available assessment (LV), and after a 9-week washout.

Findings: In total, 32/39 patients completed Part B; median Part B treatment duration: 99 weeks. Patients switching from placebo to sutimlimab in Part B experienced rapid improvement in Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue score and other PROs. Sustained, clinically important improvements in FACIT-Fatigue were observed throughout Part B in patients who switched to sutimlimab and those continuing sutimlimab treatment (combined-group mean [SE] change from baseline at LV: 8.8 [2.1]). Similarly, the combined-group mean [SE] change for 12-Item Short Form Health Survey physical (4.9 [1.7]) and mental (4.0 [1.8]) component scores exceeded clinically important changes from baseline at LV. EuroQol visual analogue scale showed consistent and sustained increases from baseline with sutimlimab treatment. Following a 9-week washout, all PROs approached baseline values.

Interpretation: Continued inhibition of the classical complement pathway with sutimlimab results in meaningful long-term improvements in PROs (fatigue and QoL) in patients with CAD.

Funding: Sanofi.

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来源期刊
EClinicalMedicine
EClinicalMedicine Medicine-Medicine (all)
CiteScore
18.90
自引率
1.30%
发文量
506
审稿时长
22 days
期刊介绍: eClinicalMedicine is a gold open-access clinical journal designed to support frontline health professionals in addressing the complex and rapid health transitions affecting societies globally. The journal aims to assist practitioners in overcoming healthcare challenges across diverse communities, spanning diagnosis, treatment, prevention, and health promotion. Integrating disciplines from various specialties and life stages, it seeks to enhance health systems as fundamental institutions within societies. With a forward-thinking approach, eClinicalMedicine aims to redefine the future of healthcare.
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