University of Connecticut, Farmington, Connecticut; Probity Medical Research, Waterloo, Ontario, Canada.
New York Medical College, Valhalla, New York.
J Am Acad Dermatol. 2017 Apr;76(4):655-661. doi: 10.1016/j.jaad.2016.11.043. Epub 2017 Jan 10.
Psoriasis is a chronic condition with negative impact on patients' quality of life that most often requires lifelong effective and safe treatment.
This analysis focused on the effect of secukinumab treatment on patient-reported health-related quality of life as assessed by the Dermatology Life Quality Index (DLQI) in patients with moderate to severe psoriasis.
The proportion of subjects achieving DLQI score 0/1 response at week 24, time to DLQI score 0/1 response, and sustained DLQI score 0/1 response up to week 52 were compared between secukinumab and etanercept.
Of 1470 subjects, 1144 received secukinumab and 326 received etanercept. DLQI score 0/1 response rates were significantly higher for secukinumab than for etanercept at week 24. The median time to DLQI score 0/1 response was significantly shorter for secukinumab versus etanercept (12 vs 24 weeks; P < .01). The majority of secukinumab-treated subjects achieved DLQI score 0/1 response at week 24 and sustained it through week 52 along with a 90% to 100% reduction in the Psoriasis Area and Severity Index total score response.
Placebo comparisons are limited during the maintenance period because of rerandomization at week 12.
Secukinumab treatment provided faster and greater sustained improvements in quality of life than etanercept over 52 weeks, consistent with greater clinical response.
银屑病是一种慢性疾病,对患者的生活质量有负面影响,大多数情况下需要终生进行有效和安全的治疗。
本分析重点关注司库奇尤单抗治疗对中重度银屑病患者健康相关生活质量(通过皮肤病生活质量指数[DLQI]评估)的影响。
比较司库奇尤单抗和依那西普治疗 24 周时达到 DLQI 评分 0/1 应答的患者比例、达到 DLQI 评分 0/1 应答的时间以及 52 周时持续达到 DLQI 评分 0/1 应答的比例。
在 1470 例患者中,1144 例接受了司库奇尤单抗治疗,326 例接受了依那西普治疗。司库奇尤单抗组的 DLQI 评分 0/1 应答率显著高于依那西普组。与依那西普相比,司库奇尤单抗达到 DLQI 评分 0/1 应答的中位时间更短(12 周 vs 24 周;P<.01)。大多数司库奇尤单抗治疗的患者在第 24 周时达到 DLQI 评分 0/1 应答,并在第 52 周时保持该应答,同时银屑病面积和严重程度指数(PASI)总分的应答率降低 90%~100%。
由于在第 12 周重新随机分组,在维持期进行安慰剂比较是有限的。
与依那西普相比,司库奇尤单抗治疗在 52 周内可更快且更持久地改善生活质量,与更大的临床应答一致。