Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA.
Osteoarthritis Cartilage. 2011 Jun;19(6):639-46. doi: 10.1016/j.joca.2011.01.009. Epub 2011 Jan 18.
This study was designed to evaluate the long-term safety and effectiveness of repeated doses of the humanized anti-nerve growth factor antibody, tanezumab, during open-label treatment of patients with OA knee pain.
The current study (clinicaltrials.gov identifier: NCT00399490) was a multicenter, phase II, open-label, multiple-dose extension of an earlier randomized clinical trial. All patients (N=281) received infusions of tanezumab 50μg/kg on Days 1 and 56 with subsequent doses administered at 8-week intervals (up to a total of eight infusions). The primary endpoint of this study was safety. Effectiveness evaluations included overall knee pain, Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index subscales, and subject global assessment (SGA) of response to therapy on 0-100 point visual analog scales.
Repeated administration of tanezumab resulted in a low incidence of treatment-related adverse events (AEs; 7.5%). The rate of serious AEs was also low (2.8%) with none considered treatment-related. Few AEs of abnormal peripheral sensation were reported; hypoesthesia was reported by nine patients (3.2%), paresthesia by seven patients (2.5%), and hyperesthesia, peripheral neuropathy, and sensory disturbance were each reported by one patient (0.4% for each). Most AEs of abnormal peripheral sensation were rated as mild (95%) and the majority (65%) resolved before study completion. At Week 8, overall knee pain and SGA improved from baseline by a mean (± standard error) of -12.8 (±1.78) and 8.0 (±1.66), respectively. Similar improvements occurred for WOMAC subscales.
Repeated injections of tanezumab in patients with moderate to severe knee OA provide continued pain relief and improved function with a low incidence of side effects. Additional studies to define the efficacy and duration of pain reduction and to provide a more complete assessment of long-term safety are warranted.
本研究旨在评估在开放标签治疗膝骨关节炎(OA)疼痛患者中,重复给予人源化抗神经生长因子抗体替扎尼定的长期安全性和有效性。
本研究(clinicaltrials.gov 标识符:NCT00399490)是一项多中心、二期、开放标签、多剂量扩展的早期随机临床试验。所有患者(N=281)接受替扎尼定 50μg/kg 剂量,于第 1 天和第 56 天输注,随后每 8 周给药一次(最多 8 次输注)。本研究的主要终点为安全性。有效性评估包括总体膝关节疼痛、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)量表亚量表以及治疗反应的患者整体评估(SGA)在 0-100 点视觉模拟量表上。
替扎尼定重复给药导致治疗相关不良事件(AE)发生率低(7.5%)。严重 AE 发生率也较低(2.8%),且均不认为与治疗相关。报告了少数异常外周感觉的 AE;9 例(3.2%)患者出现感觉迟钝,7 例(2.5%)患者出现感觉异常,1 例(0.4%)患者出现感觉过敏、周围神经病和感觉障碍。大多数异常外周感觉的 AE 被评为轻度(95%),大多数(65%)在研究完成前得到解决。在第 8 周时,总体膝关节疼痛和 SGA 分别从基线改善了-12.8(±1.78)和 8.0(±1.66),平均值(±标准误差)。WOMAC 亚量表也出现了类似的改善。
在中重度膝骨关节炎患者中重复给予替扎尼定注射可提供持续的疼痛缓解和功能改善,副作用发生率低。需要进一步研究来确定疼痛减轻的疗效和持续时间,并提供更全面的长期安全性评估。