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托法替布在美国和非美国类风湿性关节炎患者中的疗效与安全性:II期和III期汇总分析

Efficacy and safety of tofacitinib in US and non-US rheumatoid arthritis patients: pooled analyses of phase II and III.

作者信息

Cohen Stanley B, Koenig Andrew, Wang Lisy, Kwok Kenneth, Mebus Charles A, Riese Richard J, Fleischmann Roy M

机构信息

Metroplex Clinical Research Center, Dallas, TX, USA.

Pfizer Inc., Collegeville, PA, USA.

出版信息

Clin Exp Rheumatol. 2016 Jan-Feb;34(1):32-6. Epub 2015 Nov 17.

Abstract

OBJECTIVES

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.

METHODS

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.

RESULTS

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.

CONCLUSIONS

Patients in the US achieved similar efficacy and safety with tofacitinib 5 and 10 mg BID compared with patients in ROW.

摘要

目的

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。

方法

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。

结果

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。

结论

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。

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