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罗米司亭治疗慢性免疫性血小板减少性紫癜患者的生活质量改善:两项随机、安慰剂对照试验的结果

Improved quality of life for romiplostim-treated patients with chronic immune thrombocytopenic purpura: results from two randomized, placebo-controlled trials.

作者信息

George James N, Mathias Susan D, Go Ronald S, Guo Matthew, Henry David H, Lyons Roger, Redner Robert L, Rice Lawrence, Schipperus Martin R

机构信息

Colleges of Medicine and Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73126-0901, USA.

出版信息

Br J Haematol. 2009 Feb;144(3):409-15. doi: 10.1111/j.1365-2141.2008.07464.x. Epub 2008 Nov 11.

Abstract

Health-related quality of life (HRQoL) is a major concern for adults with chronic immune thrombocytopenic purpura (ITP) due to the symptoms associated with the disease and its treatment. This study utilized the ITP-patient assessment questionnaire (ITP-PAQ), a specialized HRQoL questionnaire for ITP, to investigate the humanistic burden of ITP and the impact of romiplostim therapy on HRQoL in two, placebo-controlled, phase 3 clinical trials of splenectomized and non-splenectomized patients. ITP-PAQ was self-administered to ITP patients at baseline, and weeks 4, 12 and 24 of treatment. Splenectomized patients had lower baseline HRQoL scores than non-splenectomized patients in seven of 10 scales (P < 0.05). After 24 weeks of romiplostim therapy, splenectomized patients showed significant improvements over placebo in four of 10 ITP-PAQ Scales (Symptoms, P = 0.0337; Bother, P = 0.0126; Social Activity, P = 0.0145; and Women's Reproductive Health, P = 0.0184). Non-splenectomized patients demonstrated significant improvement over placebo in the Activity Scale (P = 0.0458). Data pooled from the two trials, adjusted for splenectomy status, showed significant improvement for romiplostim-treated patients in six scales; Symptoms, Bother, Activity, Fear, Social Activity and Women's Reproductive Health. These results suggest that adult patients with chronic ITP have improved HRQoL following romiplostim therapy.

摘要

由于慢性免疫性血小板减少性紫癜(ITP)相关的症状及其治疗,健康相关生活质量(HRQoL)是成年ITP患者的主要关注点。本研究在两项针对脾切除和未脾切除患者的3期安慰剂对照临床试验中,使用ITP患者评估问卷(ITP-PAQ,一种专门用于ITP的HRQoL问卷)来调查ITP的人文负担以及罗米司亭治疗对HRQoL的影响。在基线以及治疗的第4、12和24周,ITP患者自行填写ITP-PAQ。在10个量表中的7个量表上,脾切除患者的基线HRQoL得分低于未脾切除患者(P < 0.05)。罗米司亭治疗24周后,在10个ITP-PAQ量表中的4个量表上,脾切除患者相对于安慰剂显示出显著改善(症状,P = 0.0337;困扰,P = 0.0126;社交活动,P = 0.0145;以及女性生殖健康,P = 0.0184)。在活动量表上,未脾切除患者相对于安慰剂显示出显著改善(P = 0.0458)。对两项试验的数据进行汇总,并根据脾切除状态进行调整后,结果显示罗米司亭治疗的患者在6个量表上有显著改善;症状、困扰、活动、恐惧、社交活动和女性生殖健康。这些结果表明,成年慢性ITP患者在接受罗米司亭治疗后HRQoL有所改善。

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