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巴瑞替尼治疗日本活动性类风湿关节炎患者的疗效和安全性:一项为期52周的随机、单盲、扩展研究。

Efficacy and safety of baricitinib in Japanese patients with active rheumatoid arthritis: A 52-week, randomized, single-blind, extension study.

作者信息

Tanaka Yoshiya, Ishii Taeko, Cai Zhihong, Schlichting Douglas, Rooney Terence, Macias William

机构信息

a First Department of Internal Medicine, School of Medicine , University of Occupational and Environmental Health , Kitakyushu , Japan.

b Medicines Development Unit Japan , Eli Lilly Japan K.K , Kobe , Japan.

出版信息

Mod Rheumatol. 2018 Jan;28(1):20-29. doi: 10.1080/14397595.2017.1307899. Epub 2017 Apr 25.

Abstract

OBJECTIVES

The objective of this study is to evaluate the efficacy and safety of long-term (64 weeks; 52-week extension of a 12-week study) baricitinib treatment in Japanese patients with active rheumatoid arthritis (RA) despite methotrexate therapy.

METHODS

Patients (N = 145) with active RA were randomized to placebo, 1mg, 2mg, 4mg, or 8mg baricitinib for the first 12 weeks. During the 52-week extension period, patients on 4mg or 8mg baricitinib remained on the same dose and all other patients were re-randomized to 4mg or 8mg baricitinib. Most patients on 8mg baricitinib were switched to 4mg by week 64 (protocol amendment); data analysis was based on the treatment group at the beginning of the extension period.

RESULTS

Increases in the American College of Rheumatology (ACR) response rates (ACR20, ACR50, and ACR70) observed during the first 12 weeks were maintained during the extension period, accompanied by improvements in ACR core components. At week 64, a large proportion of patients (>40%) had low disease activity. Most treatment-related adverse events were mild or moderate; herpes zoster was the most common reason (11/27 patients) for discontinuation.

CONCLUSIONS

The efficacy and safety profile of baricitinib was maintained during long-term treatment of Japanese patients with RA and background methotrexate therapy. Clinicaltrials.gov NCT01469013; Funding: Eli Lilly and Incyte.

摘要

目的

本研究的目的是评估巴瑞替尼长期(64周;一项12周研究的52周延长期)治疗对尽管接受甲氨蝶呤治疗但仍患有活动性类风湿性关节炎(RA)的日本患者的疗效和安全性。

方法

145例活动性RA患者在最初12周被随机分配接受安慰剂、1mg、2mg、4mg或8mg巴瑞替尼治疗。在52周延长期内,接受4mg或8mg巴瑞替尼治疗的患者维持原剂量,所有其他患者重新随机分配接受4mg或8mg巴瑞替尼治疗。大多数接受8mg巴瑞替尼治疗的患者在第64周时改为4mg(方案修订);数据分析基于延长期开始时的治疗组。

结果

在最初12周观察到的美国风湿病学会(ACR)缓解率(ACR20、ACR50和ACR70)的提高在延长期内得以维持,同时ACR核心指标也有所改善。在第64周时,很大一部分患者(>40%)疾病活动度较低。大多数与治疗相关的不良事件为轻度或中度;带状疱疹是停药的最常见原因(11/27例患者)。

结论

在对接受甲氨蝶呤背景治疗的日本RA患者进行长期治疗期间,巴瑞替尼的疗效和安全性得以维持。Clinicaltrials.gov标识符:NCT01469013;资助:礼来公司和因赛特公司。

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