中国中重度银屑病患者3期临床试验的疗效和安全性分析:伊昔单抗停药和再治疗的影响。

IF 3.4 3区 医学 Q2 MEDICINE, RESEARCH & EXPERIMENTAL Advances in Therapy Pub Date : 2024-11-13 DOI:10.1007/s12325-024-03030-5
Xinghua Gao, Weili Pan, Min Zheng, Fuqiu Li, Xiuqin Dong, Dong Lv, Zaipei Guo, Jinnan Li, Xuan Wang, Songmei Geng
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引用次数: 0

摘要

简介中国约有 230 万银屑病患者。对于中度至重度银屑病,建议进行连续治疗。本研究旨在评估在中国患者中连续治疗与间断治疗伊赛珠单抗(IXE)的疗效,以及疾病恶化后伊赛珠单抗再治疗的疗效:在这项3期、多中心、随机、双盲、安慰剂对照研究中,患者在第0周随机接受IXE或安慰剂治疗。第12周,IXE应答者(静态医生总体评估[sPGA]评分为0或1 [0,1])被重新随机分配(2:1)至IXE(IXE/IXE,连续治疗)或安慰剂(IXE/PBO,间断治疗)。重新随机分组后,病情恶化(复发,sPGA ≥ 3)的IXE/PBO患者改用每4周一次的IXE治疗(IXE/PBO + IXEQ4W,再治疗)。疗效通过评估银屑病面积和严重程度指数(PASI)75/90/100、sPGA(0,1)、皮肤科生活质量指数(DLQI)(0,1)、平均 PASI 和瘙痒数值评定量表(NRS)评分的反应率以及特殊身体部位的改善情况进行评估。安全性通过评估治疗突发不良事件(AEs)和严重不良事件进行评估:第12周时,289名IXE应答者被重新随机分配到IXE/IXE组(192名患者)和IXE/PBO组(97名患者)。直到第 60 周,IXE/IXE 组的 PASI 75 和 sPGA (0, 1) 反应率一直很高。第 60 周时,IXE/PBO 组有 88 例(90.7%)患者疾病复发;复发的中位时间约为 20 周。再治疗 24 周后,PASI 75 和 sPGA(0,1)重新恢复(IXE/PBO + IXEQ4W 组分别为 97.2% 和 74.6%)。连续治疗和再治疗患者的AEs相当:结论:在连续接受IXE治疗的中国患者中,高应答率可维持至60周。结论:在连续接受 IXE 治疗的中国患者中,60 周后仍能保持较高的应答率。试验注册号:NCT03364309:试验注册号:NCT03364309。
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Efficacy and Safety Analysis in Chinese Patients with Moderate-to-Severe Psoriasis from a Phase 3 Trial: Impact of Treatment Withdrawal and Retreatment of Ixekizumab.

Introduction: In China, approximately 2.3 million people have psoriasis. Continuous treatment is recommended for moderate-to-severe psoriasis. This study aimed to evaluate the outcomes of continuous versus interrupted ixekizumab (IXE) treatment and retreatment with IXE after disease worsening in Chinese patients.

Methods: In this Phase 3, multicenter, randomized, double-blind, placebo-controlled study, patients were randomized to IXE or placebo at Week 0. At Week 12, IXE responders (static Physician's Global Assessment [sPGA] score, 0 or 1 [0,1]) were re-randomized (2:1) to IXE (IXE/IXE, continuous treatment) or placebo (IXE/PBO, interrupted treatment). After re-randomization, treatment in IXE/PBO patients with disease worsening (relapse, sPGA ≥ 3) was switched to IXE every 4 weeks (IXE/PBO + IXEQ4W, retreatment). Efficacy was assessed by evaluating the response rates of Psoriasis Area and Severity Index (PASI) 75/90/100, sPGA (0,1), Dermatology Life Quality Index (DLQI) (0,1), mean PASI, and Itch Numerical Rating Scale (NRS) scores and improvements of special body areas. Safety was evaluated by assessing treatment-emergent adverse events (AEs) and serious AEs.

Results: At Week 12, 289 IXE responders were re-randomized to the IXE/IXE group (192 patients) and IXE/PBO group (97 patients). High rates of PASI 75 and sPGA (0, 1) responses were maintained in the IXE/IXE group until Week 60. At Week 60, 88 (90.7%) patients in the IXE/PBO group had disease relapse; the median time to relapse was approximately 20 weeks. After 24 weeks of retreatment, PASI 75 and sPGA (0, 1) were recaptured (97.2% and 74.6%, respectively, in the IXE/PBO + IXEQ4W group). AEs were comparable in patients who received continuous treatment and retreatment.

Conclusion: In Chinese patients who received continuous IXE treatment, high response rates were maintained through 60 weeks. Most patients had disease relapse after treatment withdrawal. After retreatment, most of these patients had regained and maintained response since Week 12.

Trial registration number: NCT03364309.

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来源期刊
Advances in Therapy
Advances in Therapy 医学-药学
CiteScore
7.20
自引率
2.60%
发文量
353
审稿时长
6-12 weeks
期刊介绍: Advances in Therapy is an international, peer reviewed, rapid-publication (peer review in 2 weeks, published 3–4 weeks from acceptance) journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of therapeutics and interventions (including devices) across all therapeutic areas. Studies relating to diagnostics and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Advances in 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 all scientifically and ethically sound research.
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