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安罗替尼,一种抗白细胞介素 13 单克隆抗体,在活动期 UC 中的疗效和安全性:来自 IIa 期随机多中心研究的结果。

Anrukinzumab, an anti-interleukin 13 monoclonal antibody, in active UC: efficacy and safety from a phase IIa randomised multicentre study.

机构信息

McMaster University, Hamilton, Ontario, Canada Medical University of Vienna, Vienna, Austria.

Hospital Clinic I Provincial de Barcelona, CIBERehd, IDIBAPS, Barcelona, Spain.

出版信息

Gut. 2015 Jun;64(6):894-900. doi: 10.1136/gutjnl-2014-308337. Epub 2015 Jan 7.

Abstract

OBJECTIVE

Interleukin 13 (IL-13) is thought to play a key role as an effector cytokine in UC. Anrukinzumab, a humanised antibody that inhibits human IL-13, was evaluated for the treatment of UC.

DESIGN

In a multicentre, randomised, double-blind, placebo-controlled study, patients with active UC (Mayo score ≥4 and <10) were randomised to anrukinzumab 200, 400 or 600 mg or placebo. Patients received five intravenous administrations over 14 weeks. The primary endpoint was fold change from baseline in faecal calprotectin (FC) at Week 14. Secondary endpoints included safety, pharmacokinetics and IL-13 levels.

RESULTS

The modified intention-to-treat population included 84 patients (21 patients/arm). Fold change of FC from baseline at Week 14 was not significantly different for any treatment groups compared with the placebo. The study had a high dropout rate, in part, related to lack of efficacy. The exploratory comparisons of each dose were not significantly different from placebo in terms of change from baseline in total Mayo score, clinical response, clinical remission and proportion of subjects with mucosal healing. An increase in serum total IL-13 (free and bound to anrukinzumab) was observed for all anrukinzumab groups but not with placebo. This suggests significant binding of anrukinzumab to IL-13. The safety profile was not different between the anrukinzumab and placebo groups.

CONCLUSIONS

A statistically significant therapeutic effect of anrukinzumab could not be demonstrated in patients with active UC in spite of binding of anrukinzumab to IL-13.

TRIAL REGISTRATION NUMBER

ClinicalTrials.gov number NCT01284062.

摘要

目的

白细胞介素 13(IL-13)被认为在 UC 中作为效应细胞因子发挥关键作用。Anrukinzumab 是一种人源化抗体,可抑制人 IL-13,用于治疗 UC。

设计

在一项多中心、随机、双盲、安慰剂对照研究中,患有活动期 UC(Mayo 评分≥4 且<10)的患者被随机分配至 anrukinzumab 200、400 或 600mg 或安慰剂组。患者接受 14 周内的五次静脉给药。主要终点是第 14 周时粪便钙卫蛋白(FC)与基线相比的变化倍数。次要终点包括安全性、药代动力学和 IL-13 水平。

结果

改良意向治疗人群包括 84 例患者(每组 21 例)。与安慰剂相比,任何治疗组在第 14 周时 FC 与基线相比的变化倍数均无显著差异。该研究的脱落率较高,部分原因是疗效不佳。就总 Mayo 评分、临床反应、临床缓解和黏膜愈合的患者比例而言,每种剂量的探索性比较与安慰剂相比均无显著差异。所有 anrukinzumab 组均观察到血清总 IL-13(游离和与 anrukinzumab 结合)增加,但安慰剂组则没有。这表明 anrukinzumab 与 IL-13 结合显著。anrukinzumab 组和安慰剂组的安全性特征无差异。

结论

尽管 anrukinzumab 与 IL-13 结合,但在活动性 UC 患者中仍未能证明 anrukinzumab 的治疗效果具有统计学意义。

临床试验注册号

ClinicalTrials.gov 编号 NCT01284062。

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