Rheumazentrum Ruhrgebiet, Landgrafenstrasse 15, D-44652 Herne, Germany.
Ann Rheum Dis. 2012 May;71(5):661-7. doi: 10.1136/ard.2011.154799. Epub 2011 Oct 19.
To assess the efficacy and safety of golimumab over 104 weeks in patients with active ankylosing spondylitis.
At baseline, patients with active ankylosing spondylitis (n=356) were randomly assigned (1:1.8:1.8) to subcutaneous injections of placebo (group 1), golimumab 50 mg (group 2) or golimumab 100 mg (group 3) every 4 weeks. At week 16, patients in groups 1 and 2 with <20% improvement in total back pain and morning stiffness entered early escape to 50 or 100 mg, respectively. At week 24, patients still receiving placebo crossed over to golimumab 50 mg. Findings through week 24 were previously reported; those through week 104 are presented herein.
At week 104, 38.5%, 60.1% and 71.4% of patients in groups 1, 2 and 3, respectively, had at least 20% improvement in the Assessment in SpondyloArthritis international Society response criteria (ASAS20); 38.5%, 55.8% and 54.3% had an ASAS40 response and 21.8%, 31.9% and 30.7% were in ASAS partial remission. Mean Bath Ankylosing Spondylitis Disease Activity Index and Bath Ankylosing Spondylitis Functional Index scores were <3 at week 104 for all the treatment regimens. Golimumab safety through week 104 was similar to that through week 24.
Clinical response that was achieved by patients receiving golimumab through 24 weeks was sustained through 52 and 104 weeks. The golimumab safety profile appeared to be consistent with the known safety profile of tumour necrosis factor inhibitors.
评估戈利木单抗治疗活动期强直性脊柱炎患者 104 周的疗效和安全性。
在基线时,356 例活动期强直性脊柱炎患者被随机分配(1:1.8:1.8)接受安慰剂(第 1 组)、戈利木单抗 50mg(第 2 组)或戈利木单抗 100mg(第 3 组)每 4 周皮下注射一次。在第 16 周时,第 1 组和第 2 组中总背痛和晨僵改善<20%的患者分别早期改用戈利木单抗 50 或 100mg。在第 24 周时,仍接受安慰剂的患者交叉至戈利木单抗 50mg。第 24 周的结果之前已报道;此处报告第 104 周的结果。
在第 104 周时,第 1 组、第 2 组和第 3 组分别有 38.5%、60.1%和 71.4%的患者达到了强直性脊柱炎国际评估协会反应标准(ASAS20)的至少 20%改善;38.5%、55.8%和 54.3%的患者达到了 ASAS40 反应,21.8%、31.9%和 30.7%的患者处于 ASAS 部分缓解。所有治疗方案在第 104 周时 Bath 强直性脊柱炎疾病活动指数和 Bath 强直性脊柱炎功能指数的平均值均<3。在第 104 周时,戈利木单抗的安全性与第 24 周时相似。
在第 24 周接受戈利木单抗治疗的患者在第 52 周和第 104 周时的临床反应得到了维持。戈利木单抗的安全性特征似乎与肿瘤坏死因子抑制剂的已知安全性特征一致。