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长期使用GCSB-5对骨关节炎患者胃肠道的安全性及疗效:一项为期24周的多中心研究。

Gastrointestinal safety and efficacy of long-term GCSB-5 use in patients with osteoarthritis: A 24-week, multicenter study.

作者信息

Ha Chul-Won, Park Yong-Beom, Kyung Hee-Soo, Han Chung-Soo, Bae Ki-Cheor, Lim Hong-Chul, Park Sang-Eun, Lee Myung Chul, Won Ye-Yeon, Lee Dong-Chul, Cho Sung-Do, Kim Chang-Wan, Kim Jin-Goo, Kang Joon-Soon, Lee Ju-Hong, Choi Eui-Sung, Seon Jong-Keun, Lee Woo-Suk, Bin Seong-Il

机构信息

Department of Orthopedic Surgery, Stem Cell & Regenerative Medicine Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.

Department of Orthopedic Surgery, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, South Korea.

出版信息

J Ethnopharmacol. 2016 Aug 2;189:310-8. doi: 10.1016/j.jep.2016.05.031. Epub 2016 May 16.

DOI:10.1016/j.jep.2016.05.031
PMID:27196293
Abstract

ETHNOPHARMACOLOGY RELEVANCE

A previous study indicated non-inferiority of GCSB-5 to celecoxib regarding efficacy and safety in treating OA; however, the gastrointestinal (GI) safety data was limited to 12 weeks. Accordingly, a longer term study with a larger number of patients was necessary to establish the GI safety of GCSB-5.

AIM OF STUDY

The primary goal was to determine the safety and efficacy of 24-week use of GCSB-5. The secondary goal was to compare the GI safety data of GCSB-5 with that of the previously reported Celecoxib Long-term Arthritis Safety Study (CLASS).

METHOD

This was a 24-week, multicenter, single-arm phase IV Study for the safety and efficacy of GCSB-5. A total of 761 patients were enrolled and 756 patients received at least one dose of GCSB-5. Among them, 629 patients (82.7%) completed the 24 week follow up. The primary goal was to determine the safety and efficacy of GCSB-5 for 24 weeks. The secondary goal was to compare the GI safety data of GCSB-5 with that of the previously reported Celecoxib Long-term Arthritis Safety Study (CLASS).

RESULTS

The incidence of GI disorders of GCSB-5 was 23.7%. The annual rate of perforation, ulcer obstruction, or bleeding (PUB) incidence was 0.0%. The drop-out rate due to GI disorders following GCSB-5 use was 4.8%. Compared to celecoxib data from CLASS, the incidence of GI disorders (23.7% vs. 31.4%, p<0.001), annual rate of PUB and gastroduodenal ulcers (0.0% vs 2.2%, p=0.004), and drop-out rate due to GI disorders following GCSB-5 use were significantly low (4.8% vs 8.7%, p<0.001). Efficacy was proven by significant improvements in Western Ontario McMaster Questionnaire (WOMAC) scale, Korean Knee Score (KKS), 100-mm pain visual analogue scale (VAS), and physician's global assessments of patient's response to therapy (PGART).

CONCLUSIONS

The safety and efficacy profile of GCSB-5 are comparable to celecoxib. These results indicate GCSB-5 is safe for a long-term treatment of knee OA patients.

TRIAL REGISTRATION

ClinicalTrials.gov (NCT01604239).

摘要

民族药理学相关性

先前一项研究表明,在治疗骨关节炎的疗效和安全性方面,GCSB-5不劣于塞来昔布;然而,胃肠道(GI)安全性数据仅限于12周。因此,有必要进行一项纳入更多患者的长期研究,以确定GCSB-5的胃肠道安全性。

研究目的

主要目标是确定使用GCSB-5 24周的安全性和有效性。次要目标是将GCSB-5的胃肠道安全性数据与先前报道的塞来昔布长期关节炎安全性研究(CLASS)的数据进行比较。

方法

这是一项为期24周的多中心、单臂IV期研究,旨在评估GCSB-5的安全性和有效性。共招募了761名患者,756名患者接受了至少一剂GCSB-5。其中,629名患者(82.7%)完成了24周的随访。主要目标是确定GCSB-5使用24周的安全性和有效性。次要目标是将GCSB-5的胃肠道安全性数据与先前报道的塞来昔布长期关节炎安全性研究(CLASS)的数据进行比较。

结果

GCSB-5引起的胃肠道疾病发生率为23.7%。穿孔、溃疡梗阻或出血(PUB)年发生率为0.0%。使用GCSB-5后因胃肠道疾病导致的退出率为4.8%。与CLASS研究中的塞来昔布数据相比,胃肠道疾病发生率(23.7%对31.4%,p<0.001)、PUB和胃十二指肠溃疡年发生率(0.0%对2.2%,p=0.004)以及使用GCSB-5后因胃肠道疾病导致的退出率均显著较低(4.8%对8.7%,p<0.001)。西安大略和麦克马斯特大学骨关节炎指数(WOMAC)量表、韩国膝关节评分(KKS)、100毫米疼痛视觉模拟量表(VAS)以及医生对患者治疗反应的整体评估(PGART)的显著改善证明了其疗效。

结论

GCSB-5的安全性和有效性与塞来昔布相当。这些结果表明,GCSB-5对膝关节骨关节炎患者进行长期治疗是安全的。

试验注册

ClinicalTrials.gov(NCT01604239)。

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