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甲氨蝶呤治疗应答不足的活动性类风湿关节炎日本患者中abatacept 的 II 期剂量反应研究。

Phase II dose-response study of abatacept in Japanese patients with active rheumatoid arthritis with an inadequate response to methotrexate.

机构信息

Division of Rheumatology, Department of Internal Medicine, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.

出版信息

Mod Rheumatol. 2013 Mar;23(2):226-35. doi: 10.1007/s10165-012-0668-z. Epub 2012 Jun 9.

Abstract

OBJECTIVE

The objective of this study was to assess the response to abatacept at doses of 2 mg/kg and 10 mg/kg compared to placebo in patients with active rheumatoid arthritis (RA) with an inadequate clinical response to methotrexate (MTX).

METHODS

In this multicenter, placebo-controlled, double-blind, parallel-group, dose-response study, 195 Japanese patients with active RA with an inadequate response to MTX were randomized 1:1:1 to receive 10 mg/kg or 2 mg/kg abatacept plus MTX, or placebo plus MTX, for 24 weeks.

RESULTS

Abatacept demonstrated a dose-response relationship when given at 2 and 10 mg/kg. Based on the American College of Rheumatology criteria (20, 50, and 70 %), the responses to 10 mg/kg abatacept were significantly greater than those to placebo at week 24 (p < 0.001). Smaller yet statistically significant responses were also seen in the 2 mg/kg abatacept group. Overall rates of adverse events, serious adverse events, and treatment discontinuations because of adverse events were comparable in all three groups.

CONCLUSIONS

Abatacept (2 mg/kg and 10 mg/kg) showed a dose-response relationship in Japanese patients with active RA with an inadequate clinical response to MTX. Administration of abatacept in combination with MTX for 24 weeks was well tolerated.

摘要

目的

本研究旨在评估在对甲氨蝶呤(MTX)应答不足的活动性类风湿关节炎(RA)患者中,与安慰剂相比,阿巴西普 2mg/kg 和 10mg/kg 剂量的应答情况。

方法

在这项多中心、安慰剂对照、双盲、平行组、剂量反应研究中,195 例对 MTX 应答不足的日本活动性 RA 患者按 1:1:1 的比例随机分配,接受 10mg/kg 或 2mg/kg 阿巴西普加 MTX,或安慰剂加 MTX,治疗 24 周。

结果

阿巴西普在 2mg/kg 和 10mg/kg 时表现出剂量反应关系。根据美国风湿病学会标准(20、50 和 70%),在第 24 周,10mg/kg 阿巴西普的应答显著优于安慰剂(p<0.001)。在 2mg/kg 阿巴西普组也观察到了较小但有统计学意义的应答。在所有三组中,不良事件、严重不良事件和因不良事件而停药的总发生率相当。

结论

阿巴西普(2mg/kg 和 10mg/kg)在对 MTX 应答不足的日本活动性 RA 患者中表现出剂量反应关系。阿巴西普联合 MTX 治疗 24 周耐受性良好。

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