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强直性脊柱炎患者从参比英夫利昔单抗转换为CT-P13与继续使用CT-P13的疗效及安全性比较:来自PLANETAS扩展研究的102周数据

Efficacy and safety of switching from reference infliximab to CT-P13 compared with maintenance of CT-P13 in ankylosing spondylitis: 102-week data from the PLANETAS extension study.

作者信息

Park Won, Yoo Dae Hyun, Miranda Pedro, Brzosko Marek, Wiland Piotr, Gutierrez-Ureña Sergio, Mikazane Helena, Lee Yeon-Ah, Smiyan Svitlana, Lim Mie-Jin, Kadinov Vladimir, Abud-Mendoza Carlos, Kim HoUng, Lee Sang Joon, Bae YunJu, Kim SuYeon, Braun Jürgen

机构信息

IN-HA University, School of Medicine, Medicine/Rheumatology, Incheon, Republic of Korea.

Hanyang University Hospital for Rheumatic Diseases, Seoul, Republic of Korea.

出版信息

Ann Rheum Dis. 2017 Feb;76(2):346-354. doi: 10.1136/annrheumdis-2015-208783. Epub 2016 Apr 26.

Abstract

OBJECTIVES

To investigate the efficacy and safety of switching from infliximab reference product (RP) to its biosimilar or maintaining biosimilar treatment in patients with ankylosing spondylitis (AS).

METHODS

This open-label extension study recruited patients with AS who completed a 54-week, randomised controlled study comparing CT-P13 with RP (PLANETAS). CT-P13 (5 mg/kg) was administered intravenously every 8 weeks from week 62 to week 102. Efficacy end points included the proportion of patients achieving Assessment of SpondyloArthritis international Society (ASAS)20. Antidrug antibodies (ADAs) were measured using an electrochemiluminescent method. Data were analysed for patients treated with CT-P13 in the main PLANETAS study and the extension (maintenance group) and those who were switched to CT-P13 during the extension study (switch group).

RESULTS

Overall, 174 (82.9%) of 210 patients who completed the first 54 weeks of PLANETAS and agreed to participate in the extension were enrolled. Among these, 88 were maintained on CT-P13 and 86 were switched to CT-P13 from RP. In these maintenance and switch groups, respectively, ASAS20 response rates at week 102 were 80.7% and 76.9%. ASAS40 and ASAS partial remission were also similar between groups. ADA positivity rates were comparable (week 102: 23.3% vs 27.4%). Adverse events led to treatment discontinuation during the extension study in 3 (3.3%) and 4 (4.8%) patients, respectively.

CONCLUSIONS

This is the first study to show that switching from RP to its biosimilar CT-P13 is possible without negative effects on safety or efficacy in patients with AS. In the maintenance group, CT-P13 was effective and well tolerated over 2 years of treatment.

TRIAL REGISTRATION NUMBER

NCT01571206; Results.

摘要

目的

探讨强直性脊柱炎(AS)患者从英夫利昔单抗参比制剂(RP)转换为其生物类似药或维持生物类似药治疗的疗效和安全性。

方法

这项开放标签扩展研究招募了完成一项为期54周的将CT-P13与RP进行比较的随机对照研究(PLANETAS)的AS患者。从第62周开始至第102周,每8周静脉注射一次CT-P13(5mg/kg)。疗效终点包括达到国际脊柱关节炎协会(ASAS)20评估标准的患者比例。采用电化学发光法检测抗药抗体(ADA)。对PLANETAS主要研究和扩展研究中接受CT-P13治疗的患者(维持组)以及在扩展研究期间转换为CT-P13治疗的患者(转换组)的数据进行分析。

结果

总体而言,210例完成PLANETAS前54周并同意参与扩展研究的患者中有174例(82.9%)被纳入。其中,88例继续使用CT-P13治疗,86例从RP转换为CT-P13治疗。在这些维持组和转换组中,第102周时ASAS20缓解率分别为80.7%和76.9%。两组间ASAS40缓解率和ASAS部分缓解率也相似。ADA阳性率相当(第102周时:23.3%对27.4%)。在扩展研究期间,分别有3例(3.3%)和4例(4.8%)患者因不良事件导致治疗中断。

结论

这是第一项表明AS患者从RP转换为其生物类似药CT-P13对安全性和疗效无负面影响的研究。在维持组中,CT-P13在2年的治疗期内疗效显著且耐受性良好。

试验注册号

NCT01571206;结果

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c7b6/5284340/93b3d814171a/annrheumdis-2015-208783f01.jpg

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