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布罗达单抗治疗对银屑病症状及健康相关生活质量的影响:采用一种新的患者报告结局指标——银屑病症状量表

Impact of brodalumab treatment on psoriasis symptoms and health-related quality of life: use of a novel patient-reported outcome measure, the Psoriasis Symptom Inventory.

作者信息

Gordon K B, Kimball A B, Chau D, Viswanathan H N, Li J, Revicki D A, Kricorian G, Ortmeier B G

机构信息

Department of Dermatology, Northwestern University, Feinberg School of Medicine, 676 N. St Clair St, Suite 1600, Chicago, IL, 60611, U.S.A.

出版信息

Br J Dermatol. 2014 Mar;170(3):705-15. doi: 10.1111/bjd.12636.

Abstract

BACKGROUND

Psoriasis symptoms have a significant negative impact on health-related quality of life, impairing physical functioning and well-being.

OBJECTIVE

To evaluate the impact of brodalumab, a human anti-interleukin-17R monoclonal antibody, on psoriasis symptom severity as measured by a novel patient-reported outcome measure, the Psoriasis Symptom Inventory, and dermatology-specific health-related quality of life as measured by the Dermatology Life Quality Index (DLQI).

METHODS

This was a secondary analysis of a phase II, randomized, double-blind, placebo-controlled clinical study of patients with moderate-to-severe psoriasis (n = 198) treated with brodalumab or placebo. This analysis assessed Psoriasis Symptom Inventory scores and DLQI scores over time. Analyses were conducted on all patients who were randomized and received one or more injections of the study drug according to intention to treat using last observation carried forward to impute missing data.

RESULTS

At week 12, subjects in the brodalumab groups had significant improvements in mean Psoriasis Symptom Inventory total scores [8.5 (70 mg), 15.8 (140 mg), 16.2 (210 mg) and 12.7 (280 mg)] compared with placebo (4.8). Mean improvements in DLQI were clinically meaningful (≥ 5.7) in the brodalumab groups (6.2, 9.1, 9.6 and 7.1, respectively) and significantly greater than placebo (3.1). Improvements in Psoriasis Symptom Inventory were observed as early as week 2 and in DLQI by week 4. All eight Psoriasis Symptom Inventory item scores improved significantly among the brodalumab groups by week 12.

CONCLUSIONS

Results were from a single randomized clinical trial and may not generalize to broader patient populations. However, treatment with brodalumab provided significant improvement in psoriasis symptoms in patients with moderate-to-severe psoriasis.

摘要

背景

银屑病症状对健康相关生活质量有显著负面影响,损害身体功能和幸福感。

目的

通过一种新的患者报告结局指标——银屑病症状量表,以及皮肤科特异性健康相关生活质量指标——皮肤病生活质量指数(DLQI),评估人抗白细胞介素-17R单克隆抗体布罗达单抗对银屑病症状严重程度的影响。

方法

这是一项对198例中重度银屑病患者进行的II期随机、双盲、安慰剂对照临床研究的二次分析,患者接受布罗达单抗或安慰剂治疗。该分析评估了随时间变化的银屑病症状量表得分和DLQI得分。对所有随机分组并根据意向性治疗接受一次或多次研究药物注射的患者进行分析,采用末次观察值结转法估算缺失数据。

结果

在第12周时,与安慰剂组(4.8)相比,布罗达单抗各治疗组患者的银屑病症状量表总分均值均有显著改善[8.5(70mg)、15.8(140mg)、16.2(210mg)和12.7(280mg)]。布罗达单抗各治疗组的DLQI平均改善具有临床意义(≥5.7)(分别为6.2、9.1、9.6和7.1),且显著大于安慰剂组(3.1)。银屑病症状量表得分在第2周时即出现改善,DLQI得分在第4周时出现改善。到第12周时,布罗达单抗各治疗组的银屑病症状量表所有8项得分均有显著改善。

结论

结果来自一项单一的随机临床试验,可能无法推广至更广泛的患者群体。然而,布罗达单抗治疗可使中重度银屑病患者的银屑病症状得到显著改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9ebe/4153951/bd6dc6e77b59/bjd0170-0705-f1.jpg

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