中度至重度特应性皮炎患者接受莱布利珠单抗治疗一年后反应稳定,无波动或波动极小。

IF 3.5 3区 医学 Q1 DERMATOLOGY Dermatology and Therapy Pub Date : 2024-08-01 Epub Date: 2024-08-10 DOI:10.1007/s13555-024-01226-9
Jonathan I Silverberg, Andreas Wollenberg, Linda Stein Gold, James Del Rosso, Gil Yosipovitch, Peter Lio, Jose-Manuel Carrascosa, Gaia Gallo, Yuxin Ding, Zhenhui Xu, Marta Casillas, Evangeline Pierce, Helena Agell, Sonja Ständer
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引用次数: 0

摘要

简介Lebrikizumab是一种新型单克隆抗体,在多项三期临床试验中对中重度特应性皮炎(AD)患者疗效确切。中重度特应性皮炎患者的最终治疗目标之一是实现疾病的稳定控制,而无需考虑未来的生活规划:在ADvocate1和ADvocate2中,第16周时符合方案定义的应答标准的来布利珠单抗治疗患者被以2:2:1的比例重新随机分配到每2周(Q2W)接受一次来布利珠单抗治疗、每4周(Q4W)接受一次来布利珠单抗治疗或每2周(Q2W)接受一次安慰剂治疗(来布利珠单抗停药),持续36周。在这项事后分析中,我们评估了在 36 周维持期内疗效无波动或波动极小的患者比例,并绘制了单个患者的轨迹图。我们将无波动或波动极小定义为达到并维持所定义的终点(湿疹面积和严重程度指数[EASI 75]改善≥75%,EASI改善≥90%,瘙痒数值评定量表[NRS]改善≥4分,或瘙痒数值评定量表[NRS]改善≥3分)的研究访问次数≥80%。如果患者使用了抢救药物、中断了治疗或转入逃避治疗组,在该事件发生时或发生后收集的数据将被归为无应答:维持 EASI 75 且无波动或波动极小的来布珠单抗应答者比例分别为 70.8%(来布珠单抗 Q2W)、71.2%(来布珠单抗 Q4W)和 60.0%(来布珠单抗停药)。基线瘙痒NRS≥4且在第16周时瘙痒NRS改善≥4点的患者中,66.1%(来布珠单抗Q2W)、62.7%(来布珠单抗Q4W)和55.2%(来布珠单抗停药)的瘙痒NRS改善≥4点,且无波动或波动极小:结论:在第16周达到应答标准并继续使用来布瑞珠单抗Q2W或Q4W治疗的患者表现出了稳定的应答,在皮肤和瘙痒方面的疗效没有波动或波动很小,直到第52周:临床试验注册:NCT04146363(ADvocate1)和NCT04178967(ADvocate2)。
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Patients with Moderate-to-Severe Atopic Dermatitis Maintain Stable Response with No or Minimal Fluctuations with 1 Year of Lebrikizumab Treatment.

Introduction: Lebrikizumab is a novel monoclonal antibody with established efficacy in patients with moderate-to-severe atopic dermatitis (AD) in multiple Phase 3 trials. One of the ultimate treatment goals for patients with moderate-to-severe AD is to achieve stable disease control without concern for planning future life events.

Methods: In ADvocate1 and ADvocate2, lebrikizumab-treated patients meeting the protocol-defined response criteria at Week 16 were re-randomized 2:2:1 to receive lebrikizumab every 2 weeks (Q2W), lebrikizumab every 4 weeks (Q4W), or placebo Q2W (lebrikizumab withdrawal) for 36 additional weeks. In this post hoc analysis, we evaluated the proportions of patients with no or minimal fluctuations of efficacy during the 36-week maintenance period and plotted individual patient trajectories. We defined no or minimal fluctuations as achieving and maintaining the defined endpoint (≥ 75% improvement in the Eczema Area and Severity Index [EASI 75], ≥ 90% improvement in EASI, Pruritus Numeric Rating Scale [NRS] ≥ 4-point improvement, or Pruritus NRS ≥ 3-point improvement) for ≥ 80% of the study visits. If patients used rescue medication, discontinued treatment, or transferred to the escape arm, data collected at or after the event were imputed as non-response.

Results: The proportions of lebrikizumab responders who maintained EASI 75 with no or minimal fluctuations were 70.8% (lebrikizumab Q2W), 71.2% (lebrikizumab Q4W), and 60.0% (lebrikizumab withdrawal). Of the patients with baseline Pruritus NRS ≥ 4 and who achieved ≥ 4-point improvement at Week 16, 66.1% (lebrikizumab Q2W), 62.7% (lebrikizumab Q4W), and 55.2% (lebrikizumab withdrawal) maintained ≥ 4-point Pruritus NRS improvement with no or minimal fluctuations.

Conclusions: Patients who met the response criteria at Week 16 and continued treatment with lebrikizumab Q2W or Q4W demonstrated a stable response with no or minimal fluctuations of efficacy in measures of skin and itch up to Week 52.

Clinical trial registration: NCT04146363 (ADvocate1) and NCT04178967 (ADvocate2).

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来源期刊
Dermatology and Therapy
Dermatology and Therapy Medicine-Dermatology
CiteScore
6.00
自引率
8.80%
发文量
187
审稿时长
6 weeks
期刊介绍: Dermatology and Therapy is an international, open access, peer-reviewed, rapid publication journal (peer review in 2 weeks, published 3–4 weeks from acceptance). The journal is dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of dermatological therapies. Studies relating to diagnosis, pharmacoeconomics, public health and epidemiology, quality of life, and patient care, management, and education are also encouraged. Areas of focus include, but are not limited to all clinical aspects of dermatology, such as skin pharmacology; skin development and aging; prevention, diagnosis, and management of skin disorders and melanomas; research into dermal structures and pathology; and all areas of aesthetic dermatology, including skin maintenance, dermatological surgery, and lasers. The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports/case series, trial protocols, and short communications. Dermatology and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an International and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of quality research, which may be considered of insufficient interest by other journals. The journal appeals to a global audience and receives submissions from all over the world.
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