Cohen Stanley B, Koenig Andrew, Wang Lisy, Kwok Kenneth, Mebus Charles A, Riese Richard J, Fleischmann Roy M
Metroplex Clinical Research Center, Dallas, TX, USA.
Pfizer Inc., Collegeville, PA, USA.
Clin Exp Rheumatol. 2016 Jan-Feb;34(1):32-6. Epub 2015 Nov 17.
Tofacitinib is an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis. This post-hoc pooled analysis assessed commonalities and differences in tofacitinib efficacy and safety for US versus rest of the world (ROW) populations.
Pooled phase (P) III data from patients receiving tofacitinib 5 or 10 mg twice daily (BID) or placebo were assessed for efficacy at Month 3 and for safety outcomes over 12 months. For adverse events of special interest, data on tofacitinib 5 or 10 mg BID or placebo were pooled from six PII and five PIII randomised studies.
PIII data were available for 664 vs. 2447 and PII/PIII data for 943 vs. 3567 US vs. ROW patients, respectively. The US population had a higher proportion of Caucasians (81.5% vs. 54.4%), lower proportion of Asians (1.0% vs. 34.6%), and higher mean body weight (85.7 vs. 66.2 kg) and body mass index (31.5 vs. 25.6 kg/m2) compared with ROW. At Month 3, PIII efficacy was similar between US and ROW as assessed by ACR 20/50/70 response rates, remission rates (DAS 28-4[ESR]<2.6), and HAQ-DI scores. Diarrhoea, peripheral oedema, and upper respiratory tract infection occurred in >5% of PIII patients in the US population. Incidence rates for adverse events of special interest were similar between the US and ROW PII/PIII populations.
Patients in the US achieved similar efficacy and safety with tofacitinib 5 and 10 mg BID compared with patients in ROW.
托法替布是一种用于治疗类风湿性关节炎的口服 Janus 激酶抑制剂。这项事后汇总分析评估了托法替布在美国人群与世界其他地区(ROW)人群中疗效和安全性的异同。
汇总来自接受每日两次 5 毫克或 10 毫克托法替布(BID)或安慰剂治疗的患者的 III 期数据,评估第 3 个月时的疗效以及 12 个月内的安全性结果。对于特别关注的不良事件,汇总来自六项 II 期和五项 III 期随机研究中每日两次 5 毫克或 10 毫克托法替布或安慰剂的数据。
分别有 664 名美国患者和 2447 名 ROW 患者有 III 期数据,943 名美国患者和 3567 名 ROW 患者有 II 期/III 期数据。与 ROW 相比,美国人群中白种人比例更高(81.摘要:5% 对 54.4%),亚洲人比例更低(1.0% 对 34.6%),平均体重更高(85.7 对 66.2 千克),体重指数更高(31.5 对 25.6 千克/平方米)。在第 3 个月时,根据美国风湿病学会(ACR)20/50/70 反应率、缓解率(疾病活动度评分 28-4[红细胞沉降率]<2.6)和健康评估问卷残疾指数(HAQ-DI)评分评估,美国和 ROW 的 III 期疗效相似。在美国人群中,超过 5% 的 III 期患者出现腹泻、外周性水肿和上呼吸道感染。美国和 ROW 的 II 期/III 期人群中特别关注的不良事件发生率相似。
美国患者使用每日两次 5 毫克和 10 毫克托法替布的疗效和安全性与 ROW 患者相似。