TYK2/JAK1抑制剂Brepocitinib治疗活动性银屑病关节炎的疗效和安全性:一项IIb期随机对照试验

IF 11.4 1区 医学 Q1 RHEUMATOLOGY Arthritis & Rheumatology Pub Date : 2023-05-17 DOI:10.1002/art.42519
Philip Mease, Philip Helliwell, Paula Silwinska-Stanczyk, Malgorzata Miakisz, Andrew Ostor, Elena Peeva, Michael S. Vincent, Qiankun Sun, Vanja Sikirica, Randall Winnette, Ruolun Qiu, Gang Li, Gang Feng, Jean S. Beebe, David A. Martin
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引用次数: 2

摘要

目的布替尼是一种TYK2/JAK1抑制剂,正在开发中,可用于治疗多种免疫性疾病。在患有中度至重度活动性银屑病关节炎(PsA)的参与者中,对口服布替尼的有效性和安全性进行了长达52天的评估 周。方法在这项安慰剂对照、剂量范围、IIb期研究中,参与者被随机分为每天一次接受10 mg、30 mg或60 mg的布替尼或安慰剂,在第16周增至每天一次30 mg或60mg的布替替尼。主要终点是根据美国风湿病学会标准,在第16周疾病活动性改善20%(ACR20)的有效率。次要终点包括根据ACR50/ACR70反应标准的反应率、银屑病面积和严重程度指数(PASI75/PASI90)评分的75%和90%改善,以及第16周和第52周的最低疾病活动性(MDA)。在整个研究过程中对不良事件进行监测。结果总体而言,218名参与者被随机分组并接受治疗。在第16周,每天一次的30 mg和60 mg布替尼组的ACR20应答率显著更高(66.7%[P= 0.0197]和74.6%[P= 0.0006]),与安慰剂组(43.3%)相比,ACR50/ACR70、PASI75/PASI90和MDA的应答率显著更高。反应率在第52周一直保持或提高。不良事件大多为轻度/中度;12名参与者(5.5%)中的严重不良事件(15)包括30 mg和60 mg每日一次组中的6名参与者(2.8%)感染。未发生重大心血管不良事件或死亡。结论每天1次30 mg和60 mg剂量的布替尼治疗在减轻PsA体征和症状方面优于安慰剂。在整个52周的研究中,布雷波西替尼总体耐受性良好,其安全性与其他布雷波西替尼临床试验中发现的安全性一致。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Efficacy and Safety of the TYK2/JAK1 Inhibitor Brepocitinib for Active Psoriatic Arthritis: A Phase IIb Randomized Controlled Trial

Objective

Brepocitinib is a TYK2/JAK1 inhibitor in development for the treatment of several immunologic diseases. The efficacy and safety of oral brepocitinib were assessed in participants with moderately-to-severely active psoriatic arthritis (PsA) for up to 52 weeks.

Methods

In this placebo-controlled, dose-ranging, phase IIb study, participants were randomized to receive 10 mg, 30 mg, or 60 mg of brepocitinib once daily or placebo, advancing to 30 mg or 60 mg of brepocitinib once daily at week 16. The primary endpoint was the response rate according to the American College of Rheumatology criteria for 20% improvement (ACR20) in disease activity at week 16. Secondary endpoints included response rates according to the ACR50/ACR70 response criteria, 75% and 90% improvement in the Psoriasis Area and Severity Index (PASI75/PASI90) score, and minimal disease activity (MDA) at weeks 16 and 52. Adverse events were monitored throughout the study.

Results

Overall, 218 participants were randomized and treated. At week 16, the brepocitinib 30 mg and 60 mg once daily groups had significantly greater ACR20 response rates (66.7% [P = 0.0197] and 74.6% [P = 0.0006], respectively), versus the placebo group (43.3%), and significantly higher ACR50/ACR70, PASI75/PASI90, and MDA response rates. Response rates were maintained or improved through week 52. Adverse events were mostly mild/moderate; serious adverse events (15) in 12 participants (5.5%) included infections in 6 participants (2.8%) in the brepocitinib 30 mg and 60 mg once daily groups. No major adverse cardiovascular events or deaths occurred.

Conclusion

Treatment with brepocitinib at dosages of 30 mg and 60 mg once daily was superior to placebo at reducing signs and symptoms of PsA. Brepocitinib was generally well tolerated throughout the 52-week study, with a safety profile consistent with those found in other brepocitinib clinical trials.

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来源期刊
Arthritis & Rheumatology
Arthritis & Rheumatology RHEUMATOLOGY-
CiteScore
20.90
自引率
3.00%
发文量
371
期刊介绍: Arthritis & Rheumatology is the official journal of the American College of Rheumatology and focuses on the natural history, pathophysiology, treatment, and outcome of rheumatic diseases. It is a peer-reviewed publication that aims to provide the highest quality basic and clinical research in this field. The journal covers a wide range of investigative areas and also includes review articles, editorials, and educational material for researchers and clinicians. Being recognized as a leading research journal in rheumatology, Arthritis & Rheumatology serves the global community of rheumatology investigators and clinicians.
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