长期(54 周)维多利珠单抗治疗克罗恩病的疗效和安全性结果:一项包括患者报告结果在内的前瞻性真实世界观察研究(POLONEZ II)。

IF 3.9 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Therapeutic Advances in Gastroenterology Pub Date : 2024-11-20 eCollection Date: 2024-01-01 DOI:10.1177/17562848241293938
Ariel Liebert, Maria Kłopocka, Agata Michalak, Halina Cichoz-Lach, Renata Talar-Wojnarowska, Danuta Domz Ał-Magrowska, Łukasz Konecki, Aleksandra Filipiuk, Michał Krogulecki, Maria Kopertowska-Majchrzak, Kamila Stawczyk-Eder, Katarzyna Waszak, Piotr Eder, Edyta Zagórowicz, Izabela Smoła, Krzysztof Wojciechowski, Szymon Drygała
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引用次数: 0

摘要

背景:克罗恩病(CD)活动指数(CDAI)、炎症性肠病(IBD)问卷(IBDQ)和IBD-疲劳(IBD-F)量表是有用的患者报告结果(PRO)工具,可用于评估维多珠单抗(VDZ)在CD患者中临床试验终点之外的治疗效果:评估接受VDZ治疗的中重度活动性CD患者队列中的临床反应、临床缓解、无类固醇缓解、PROs与基线相比的变化以及安全性:POLONEZ II是一项多中心、观察性、前瞻性研究,从2020年4月至2023年10月在波兰10个中心对符合VDZ报销条件的CD患者进行为期54周的治疗:第54周(W54)的主要终点是临床反应(CDAI下降⩾70分,与基线相比下降>25%)、缓解(CDAI得分⩽150)和无类固醇缓解。其他结果包括PROs(CDAI评分和健康相关生活质量)和安全性的变化。进行了卡普兰-梅耶生存分析:在98名CD患者中,平均年龄为35.2岁,57.1%为男性,72.4%患有回结肠疾病。在W54(n = 98)时,63.3%的患者获得了临床应答,48.0%获得了缓解,36.0%获得了无类固醇缓解。临床反应、缓解和无类固醇缓解的持久性(W14-W54)分别为 68.9%、62.9% 和 57.1%。POLONEZ II证明了VDZ在有效性、安全性、改善PROs和患者生活质量方面的长期实际效益:ENCePP(EUPAS32716)。
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Effectiveness and safety outcomes after long-term (54 weeks) vedolizumab therapy for Crohn's disease: a prospective, real-world observational study including patient-reported outcomes (POLONEZ II).

Background: The Crohn's Disease (CD) Activity Index (CDAI), Inflammatory Bowel Disease (IBD) Questionnaire (IBDQ), and IBD-Fatigue (IBD-F) scale are useful patient-reported outcome (PRO) tools for assessing the treatment benefits of vedolizumab (VDZ) beyond clinical trial endpoints in patients with CD.

Objectives: To assess clinical response, clinical remission, steroid-free remission, changes from baseline for PROs, and safety in a real-world cohort of patients with moderate-to-severe active CD treated with VDZ.

Design: POLONEZ II was a multicenter, observational, prospective study across 10 Polish centers from April 2020 to October 2023 for 54 weeks in patients with CD eligible for reimbursed VDZ.

Methods: Primary endpoints at week 54 (W54) were clinical response (⩾70-point reduction in CDAI and >25% reduction vs baseline), remission (CDAI score ⩽150), and steroid-free remission. Other outcomes were changes in PROs (CDAI score and health-related quality of life) and safety. Kaplan-Meier survival analyses were performed.

Results: Of 98 patients with CD, the mean age was 35.2 years, 57.1% were male, and 72.4% had an ileocolonic disease. At W54 (n = 98), 63.3% of patients achieved clinical response, 48.0% remission, and 36.0% steroid-free remission. The durability of clinical response, remission, and steroid-free remission (W14-W54) were 68.9%, 62.9%, and 57.1%, respectively. By W54, a significant reduction in the PROs, such as the total CDAI score (p < 0.001), stool frequency (p < 0.001), abdominal pain score (p < 0.001), IBDQ (p < 0.001), IBD-F (p < 0.05), and fatigue impact on daily activities (p < 0.001), was observed. During VDZ treatment, arthralgia (23.7%-8.7%) and anemia (22.6%-15.9%) decreased between baseline and W54. Non-serious adverse events (SAEs; 12.2%), SAEs (7.1%), and VDZ-related rash (1.0%) were reported. Mean CD-related hospitalization duration decreased from baseline (10.2 days) to the end of the study (5.3 days).

Conclusion: POLONEZ II demonstrated long-term real-world benefits of VDZ toward effectiveness, safety, and improved PROs and patients' quality of life.

Trial registration: ENCePP (EUPAS32716).

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来源期刊
Therapeutic Advances in Gastroenterology
Therapeutic Advances in Gastroenterology GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
6.70
自引率
2.40%
发文量
103
审稿时长
15 weeks
期刊介绍: Therapeutic Advances in Gastroenterology is an open access journal which delivers the highest quality peer-reviewed original research articles, reviews, and scholarly comment on pioneering efforts and innovative studies in the medical treatment of gastrointestinal and hepatic disorders. The journal has a strong clinical and pharmacological focus and is aimed at an international audience of clinicians and researchers in gastroenterology and related disciplines, providing an online forum for rapid dissemination of recent research and perspectives in this area. The editors welcome original research articles across all areas of gastroenterology and hepatology. The journal publishes original research articles and review articles primarily. Original research manuscripts may include laboratory, animal or human/clinical studies – all phases. Letters to the Editor and Case Reports will also be considered.
期刊最新文献
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