Kimball A B, Sobell J M, Zouboulis C C, Gu Y, Williams D A, Sundaram M, Teixeira H D, Jemec G B E
Harvard Medical School, Boston, MA, USA.
Skin Care Physicians, Chestnut Hill, MA, USA.
J Eur Acad Dermatol Venereol. 2016 Jun;30(6):989-94. doi: 10.1111/jdv.13216. Epub 2015 Jul 22.
Determining treatment response for patients with hidradenitis suppurativa (HS) can be challenging due to limitations of current disease activity evaluations.
Evaluate the novel, validated endpoint, Hidradenitis Suppurativa Clinical Response (HiSCR) and its utility as an outcome measure.
Patients with baseline total abscess and inflammatory nodule count (AN count) of at least three and draining fistula count of 20 or fewer comprised the post hoc subpopulation analysed. HiSCR (at least a 50% reduction in total AN count, with no increase in abscess count, and no increase in draining fistula count relative to baseline) and HS-PGA Response [Hidradenitis Suppurativa-Physician's Global Assessment score of clear, minimal, or mild, with at least a 2-grade improvement from baseline] were used to evaluate patient response after adalimumab treatment weekly, every other week, or placebo (1 : 1 : 1).
The subpopulation included 132 (85.7%) patients; 70.5% women and 73.5% white. At week 16, HiSCR was achieved by 54.5% receiving weekly adalimumab, 33.3% every other week, and 25.6% placebo and HS-PGA Response was achieved by 20.5% receiving weekly adalimumab, 6.7% every other week and 2.3% placebo.
HiSCR was more responsive to change than HS-PGA Response in this subpopulation.
由于目前疾病活动评估存在局限性,确定化脓性汗腺炎(HS)患者的治疗反应具有挑战性。
评估新的、经过验证的终点指标——化脓性汗腺炎临床反应(HiSCR)及其作为疗效指标的效用。
分析的事后亚组包括基线时总脓肿和炎性结节计数(AN计数)至少为3且引流瘘管计数为20或更少的患者。使用HiSCR(相对于基线,总AN计数至少减少50%,脓肿计数无增加,引流瘘管计数无增加)和HS-PGA反应[化脓性汗腺炎医生整体评估评分为清除、轻微或轻度,相对于基线至少改善2级]来评估阿达木单抗每周、每两周治疗或安慰剂(1:1:1)治疗后的患者反应。
亚组包括132名(85.7%)患者;70.5%为女性,73.5%为白人。在第16周时,每周接受阿达木单抗治疗的患者中有54.5%达到HiSCR,每两周治疗的患者中有33.3%达到HiSCR,安慰剂组中有25.6%达到HiSCR;每周接受阿达木单抗治疗的患者中有20.5%达到HS-PGA反应,每两周治疗的患者中有6.7%达到HS-PGA反应,安慰剂组中有2.3%达到HS-PGA反应。
在该亚组中,HiSCR对变化的反应比HS-PGA反应更敏感。