Rutgeerts Paul, Schreiber Stefan, Feagan Brian, Keininger Dorothy L, O'Neil Liz, Fedorak Richard N
Division of gastroenterology, University Hospital Leuven, Leuven, Belgium.
Int J Colorectal Dis. 2008 Mar;23(3):289-96. doi: 10.1007/s00384-007-0395-7. Epub 2007 Dec 11.
Certolizumab pegol, a polyethylene glycolated Fc-free Fab' was efficacious and well tolerated in patients with moderate-to-severe Crohn's disease in a previously reported randomized, placebo-controlled study. In this paper, we report the effect of certolizumab pegol on health-related quality of life (HRQoL).
Patients with moderate-to-severe active Crohn's disease (n = 292) received subcutaneous certolizumab pegol 100, 200, or 400 mg or placebo at weeks 0, 4, and 8. A post hoc analysis of the intent-to-treat population (290 patients with HRQoL data) assessed HRQoL by evaluating patients' responses to the self-administered inflammatory bowel disease questionnaire (IBDQ) at baseline and weeks 2, 4, 6, 8, 10, and 12.
Patients receiving certolizumab pegol 400 mg at weeks 0, 4, and 8 demonstrated, via their IBDQ total score, significantly (P <or= 0.05) greater improvement in HRQoL from baseline to week 12 and at all other time points compared with placebo. Moreover, HRQoL improved over time in all certolizumab pegol groups, irrespective of baseline C-reactive protein levels. Emotional well-being (IBDQ Emotional Function domain) improved throughout the study for patients receiving certolizumab pegol 400 mg. This improvement was significantly (P <or= 0.05) greater than for patients receiving placebo at all time points. In addition, systemic symptoms (IBDQ Systemic Symptoms domain) improved significantly more in patients receiving certolizumab pegol 400 mg than in those receiving placebo at weeks 4, 8, 10, and 12 (P <or= 0.05) and approached statistical significance at week 2 (P = 0.054).
This analysis suggests that certolizumab pegol 400 mg improves HRQoL in patients with moderate-to-severe Crohn's disease.
在之前一项随机、安慰剂对照研究中,聚乙二醇化无Fc段Fab'药物赛妥珠单抗在中度至重度克罗恩病患者中疗效显著且耐受性良好。本文报告赛妥珠单抗对健康相关生活质量(HRQoL)的影响。
中度至重度活动性克罗恩病患者(n = 292)在第0、4和8周接受皮下注射100、200或400 mg赛妥珠单抗或安慰剂。对意向性治疗人群(290例有HRQoL数据的患者)进行事后分析,通过评估患者在基线以及第2、4、6、8、10和12周对自行填写的炎症性肠病问卷(IBDQ)的回答来评估HRQoL。
在第0、4和8周接受400 mg赛妥珠单抗治疗的患者,通过IBDQ总分显示,与安慰剂相比,从基线至第12周以及所有其他时间点,HRQoL均有显著(P≤0.05)更大改善。此外,所有赛妥珠单抗组的HRQoL均随时间改善,与基线C反应蛋白水平无关。接受400 mg赛妥珠单抗治疗的患者在整个研究过程中情绪健康(IBDQ情绪功能领域)得到改善。在所有时间点,这种改善均显著(P≤0.05)大于接受安慰剂治疗的患者。此外,在第4、8、10和12周,接受400 mg赛妥珠单抗治疗的患者全身症状(IBDQ全身症状领域)改善明显大于接受安慰剂治疗的患者(P≤0.05),在第2周接近统计学显著性(P = 0.054)。
该分析表明,400 mg赛妥珠单抗可改善中度至重度克罗恩病患者的HRQoL。