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炎症性肠病患者从类克(Remicade®)转换为生物类似药CT-P13后的临床结局:一项前瞻性观察队列研究

Clinical Outcomes Following a Switch from Remicade® to the Biosimilar CT-P13 in Inflammatory Bowel Disease Patients: A Prospective Observational Cohort Study.

作者信息

Smits Lisa J T, Derikx Lauranne A A P, de Jong Dirk J, Boshuizen Ronald S, van Esch Aura A J, Drenth Joost P H, Hoentjen Frank

机构信息

Inflammatory Bowel Disease Centre, Department of Gastroenterology and Hepatology, Radboud university medical centre, Nijmegen, The Netherlands.

Sanquin Diagnostic Services, Biologics Laboratory, Amsterdam, The Netherlands.

出版信息

J Crohns Colitis. 2016 Nov;10(11):1287-1293. doi: 10.1093/ecco-jcc/jjw087. Epub 2016 Apr 19.

Abstract

BACKGROUND AND AIMS

The biosimilar of Remicade®, CT-P13, recently entered the European market. Clinical data on switching from Remicade® to CT-P13 in inflammatory bowel disease [IBD] are scarce. We aimed to prospectively investigate efficacy, safety, pharmacokinetic profile, and immunogenicity following a switch from Remicade® to CT-P13 in IBD patients.

METHODS

Remicade®-treated IBD patients at the Radboud university medical centre who switched to CT-P13 were included in this prospective observational cohort study. Primary endpoint was change in Harvey-Bradshaw Index for Crohn's disease [CD] and Simple Clinical Colitis Activity Index for ulcerative colitis [UC] at week 16. We measured C-reactive protein [CRP], faecal calprotectin [FCP], infliximab trough level [TL] and anti-drug antibodies [ADAs] and documented adverse events.

RESULTS

Our cohort consisted of 83 patients (28 males, 57 CD, 24 UC, 2 IBD-unclassified [IBD-U]). The median age was 36 years, range 18-79. Median change in disease activity was 0 [range -23 to +7] for CD and 0 [range -3 to +6] for UC/IBD-U. Median CRP and FCP levels did not change significantly during follow-up. Median TL increased from 3.5 µg/ml [range 0-18] to 4.2 µg/ml [range 0-21] at week 16 [p = 0.010]. Two patients developed a new detectable ADA response during follow-up and five patients discontinued CT-P13. No serious adverse events occurred.

CONCLUSIONS

We demonstrated that switching from Remicade® to CT-P13 in a real-life cohort of IBD patients did not have a significant impact on short-term clinical outcomes. These results suggest that switching from Remicade® to CT-P13 for the treatment of IBD is feasible.

摘要

背景与目的

类克(Remicade®)的生物类似药CT-P13最近进入了欧洲市场。关于炎症性肠病(IBD)患者从类克转换为CT-P13的临床数据很少。我们旨在前瞻性地研究IBD患者从类克转换为CT-P13后的疗效、安全性、药代动力学特征和免疫原性。

方法

在拉德堡德大学医学中心,将从类克转换为CT-P13治疗的IBD患者纳入这项前瞻性观察队列研究。主要终点是第16周时克罗恩病(CD)的哈维-布拉德肖指数和溃疡性结肠炎(UC)的简单临床结肠炎活动指数的变化。我们测量了C反应蛋白(CRP)、粪便钙卫蛋白(FCP)、英夫利昔单抗谷浓度(TL)和抗药抗体(ADA),并记录了不良事件。

结果

我们的队列包括83例患者(28例男性,CD患者57例,UC患者24例,未分类IBD(IBD-U)患者2例)。中位年龄为36岁,范围为18至79岁。CD患者疾病活动度的中位变化为0(范围为-23至+7),UC/IBD-U患者为0(范围为-3至+6)。随访期间,CRP和FCP的中位水平无显著变化。第16周时,TL的中位水平从3.5μg/ml(范围为0至18)增加到4.2μg/ml(范围为0至21)[p = 0.010]。两名患者在随访期间出现了新的可检测到的ADA反应,五名患者停用了CT-P13。未发生严重不良事件。

结论

我们证明,在IBD患者的真实队列中从类克转换为CT-P13对短期临床结局没有显著影响。这些结果表明,从类克转换为CT-P13治疗IBD是可行的。

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