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戈利木单抗单药治疗既往接受过改善病情抗风湿药物治疗的日本活动性类风湿关节炎患者:24 周时的 2/3 期、多中心、随机、双盲、安慰剂对照 GO-MONO 研究的结果。

Golimumab monotherapy in Japanese patients with active rheumatoid arthritis despite prior treatment with disease-modifying antirheumatic drugs: results of the phase 2/3, multicentre, randomised, double-blind, placebo-controlled GO-MONO study through 24 weeks.

机构信息

Division of Rheumatology, Keio University, Shinjuku-ku, Tokyo, Japan.

出版信息

Ann Rheum Dis. 2013 Sep 1;72(9):1488-95. doi: 10.1136/annrheumdis-2012-201796. Epub 2012 Sep 14.

Abstract

OBJECTIVE

To evaluate the efficacy and safety of golimumab 50 and 100 mg monotherapy in Japanese patients with active rheumatoid arthritis (RA) despite treatment with disease-modifying antirheumatic drugs (DMARDs).

METHODS

A total of 316 patients were randomised to receive subcutaneous injections every 4 weeks of placebo (group 1), golimumab 50 mg (group 2) or golimumab 100 mg (group 3); group 1 crossed over to golimumab 50 mg at week 16. The primary end point was the proportion of patients achieving ≥20% improvement in the American College of Rheumatology criteria (ACR20) at week 14. ACR50 and ACR70 response rates were also measured. Adverse events (AEs) were monitored throughout the study.

RESULTS

Demographics were similar across groups; the mean age was 52 years and 81.8% of patients (252/308) were female. Week 14 ACR20 response rates were significantly greater in groups 2 (51/101 (50.5%)) and 3 (60/102 (58.8%)) than in group 1 (20/105 (19.0%); p<0.0001 for both), as were ACR50 and ACR70 response rates. After placebo crossover at week 16, week 24 ACR response rates were similar in groups 1 and 2. Through week 16, 63.8% of patients in group 1, 62.4% in group 2 and 60.8% in group 3 had AEs and 1.9%, 1.0% and 2.0% had serious AEs. After week 16, one malignancy was reported (breast cancer, group 3). Infections were the most common AEs. No deaths or cases of tuberculosis were reported through week 24.

CONCLUSIONS

Golimumab monotherapy (50 and 100 mg) was effective in reducing the signs and symptoms of RA in Japanese patients with active disease despite DMARD treatment.

摘要

目的

评估戈利木单抗 50mg 和 100mg 单药治疗在日本活动性类风湿关节炎(RA)患者中的疗效和安全性,这些患者尽管接受了疾病修饰抗风湿药物(DMARDs)治疗。

方法

共 316 例患者随机接受皮下注射安慰剂(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 1 次;第 1 组在第 16 周交叉至戈利木单抗 50mg。主要终点为第 14 周时达到美国风湿病学会(ACR)20%改善标准(ACR20)的患者比例。还测量了 ACR50 和 ACR70 缓解率。在整个研究过程中监测不良事件(AE)。

结果

各组患者的人口统计学特征相似;平均年龄为 52 岁,81.8%的患者(252/308)为女性。第 14 周时,第 2 组(51/101,50.5%)和第 3 组(60/102,58.8%)的 ACR20 应答率显著高于第 1 组(20/105,19.0%;均<0.0001),ACR50 和 ACR70 应答率也是如此。第 16 周安慰剂交叉后,第 24 周时第 1 组和第 2 组的 ACR 应答率相似。第 16 周时,第 1 组 63.8%、第 2 组 62.4%和第 3 组 60.8%的患者发生 AE,1.9%、1.0%和 2.0%的患者发生严重 AE。第 16 周后,第 3 组报告了 1 例恶性肿瘤(乳腺癌)。感染是最常见的 AE。第 24 周时,无死亡或结核病病例报告。

结论

戈利木单抗单药治疗(50mg 和 100mg)在日本活动性 RA 患者中,在 DMARD 治疗的基础上,可有效减轻疾病的体征和症状。

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