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OBSERVE-5 中期分析:依那西普治疗银屑病的观察性上市后安全性注册研究。

OBSERVE-5 interim analysis: an observational postmarketing safety registry of etanercept for the treatment of psoriasis.

机构信息

Massachusetts General Hospital, Boston, Massachusetts 02114, USA.

出版信息

J Am Acad Dermatol. 2013 May;68(5):756-64. doi: 10.1016/j.jaad.2012.10.055. Epub 2013 Jan 26.

Abstract

BACKGROUND

Etanercept is approved for the treatment of chronic moderate to severe plaque psoriasis in adults.

OBJECTIVE

We sought to evaluate the long-term safety of etanercept in a real-world clinical setting. Assessment of etanercept efficacy was a secondary objective.

METHODS

OBSERVE-5 is a 5-year observational safety registry initiated in May 2006 at multiple sites in the United States and Canada. Data collection includes the number of serious adverse events, serious infectious events, and prespecified events of medical interest. Efficacy data include body surface area assessments, physician and patient global assessments of psoriasis, and the Dermatology Life Quality Index. This interim analysis presents data from the first 3 years of the follow-up period.

RESULTS

A total of 2511 patients were enrolled. Of 1890 patients continuing in the registry after 3 years, 113 were inactive for 1 to 2 years, and 115 were inactive for longer than 2 years. The 3-year incidence proportions of serious adverse events and serious infectious events based on Kaplan-Meier methodology were 0.14 and 0.04, respectively. The observed numbers of patients experiencing lymphoma, serious infectious events requiring hospitalization, nonmelanoma skin cancer, and malignancies excluding nonmelanoma skin cancer were not higher than the expected number of cases estimated from a large US administrative health claims database.

LIMITATIONS

The registry lacks a control group, and the study is too small to measure the frequency of rare events.

CONCLUSION

Etanercept demonstrated good tolerability in patients with plaque psoriasis in the clinical setting in this interim analysis. No new or unexpected safety concerns were observed.

摘要

背景

依那西普获批用于治疗成人慢性中重度斑块状银屑病。

目的

我们旨在评估依那西普在真实临床环境中的长期安全性。评估依那西普的疗效为次要目标。

方法

OBSERVE-5 是一项 5 年观察性安全性注册研究,于 2006 年 5 月在美国和加拿大的多个地点启动。数据收集包括严重不良事件、严重感染事件和预定的医学关注事件的数量。疗效数据包括体表面积评估、医生和患者的银屑病总体评估以及皮肤病生活质量指数。本中期分析呈现了随访期前 3 年的数据。

结果

共纳入 2511 例患者。1890 例患者在 3 年后继续入组该研究,其中 113 例患者失访 1-2 年,115 例患者失访超过 2 年。基于 Kaplan-Meier 方法的 3 年严重不良事件和严重感染事件发生率分别为 0.14 和 0.04。观察到的淋巴瘤、需要住院治疗的严重感染事件、非黑素瘤皮肤癌和除非黑素瘤皮肤癌以外的恶性肿瘤患者人数并不高于从大型美国行政健康保险索赔数据库中估计的预期病例数。

局限性

该注册研究缺乏对照组,且研究规模太小,无法衡量罕见事件的发生频率。

结论

在本中期分析中,依那西普在斑块状银屑病患者的临床环境中表现出良好的耐受性。未观察到新的或意外的安全性问题。

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