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托法替布治疗亚洲中重度慢性斑块型银屑病患者的疗效和安全性:一项 3 期、随机、双盲、安慰剂对照研究。

The efficacy and safety of tofacitinib in Asian patients with moderate to severe chronic plaque psoriasis: A Phase 3, randomized, double-blind, placebo-controlled study.

机构信息

Peking University People's Hospital, Department of Dermatology, Beijing, China.

National Taiwan University Hospital, Department of Dermatology, Taipei, Taiwan.

出版信息

J Dermatol Sci. 2017 Oct;88(1):36-45. doi: 10.1016/j.jdermsci.2017.05.004. Epub 2017 May 16.

Abstract

BACKGROUND

Tofacitinib is an oral Janus kinase inhibitor.

OBJECTIVE

This study assessed tofacitinib efficacy and safety vs placebo in Asian patients with moderate to severe chronic plaque psoriasis.

METHODS

Patients from China mainland, Taiwan, and Korea were randomized 2:2:1:1 to tofacitinib 5mg (N=88), tofacitinib 10mg (N=90), placebo→5mg (N=44), or placebo→10mg (N=44), twice daily (BID) for 52 weeks. Placebo-treated patients advanced to tofacitinib at Week 16. Co-primary efficacy endpoints: proportions of patients achieving Physician's Global Assessment (PGA) response ('clear' or 'almost clear') and proportion achieving ≥75% reduction from baseline Psoriasis Area and Severity Index (PASI75) at Week 16.

RESULTS

At Week 16, more patients achieved PGA and PASI75 responses with tofacitinib 5mg (52.3%; 54.6%) and 10mg (75.6%; 81.1%) BID vs placebo (19.3%; 12.5%; all p<0.0001). Of patients with a Week 16 response, 73.6% and 75.0% maintained PGA response, and 76.8% and 84.9% maintained PASI75 to Week 52 with tofacitinib 5mg and 10mg BID, respectively. Over 52 weeks, 2.2-4.5% of patients across treatment groups experienced serious adverse events, and 1.1-6.8% discontinued due to adverse events.

CONCLUSION

Tofacitinib demonstrated efficacy vs placebo at Week 16 in Asian patients with moderate to severe plaque psoriasis; efficacy was maintained through Week 52. No unexpected safety findings were observed. [NCT01815424].

摘要

背景

托法替尼是一种口服 Janus 激酶抑制剂。

目的

本研究评估托法替尼在中重度慢性斑块型银屑病亚洲患者中的疗效和安全性。

方法

中国大陆、中国台湾和韩国的患者按 2:2:1:1 的比例随机分为托法替尼 5mg(N=88)、托法替尼 10mg(N=90)、安慰剂→5mg(N=44)或安慰剂→10mg(N=44),每日两次(BID)治疗 52 周。安慰剂治疗的患者在第 16 周转为托法替尼治疗。主要疗效终点:第 16 周达到医师总体评估(PGA)应答(“清除”或“几乎清除”)的患者比例和达到从基线银屑病面积和严重程度指数(PASI75)改善≥75%的患者比例。

结果

第 16 周,托法替尼 5mg(52.3%;54.6%)和 10mg(75.6%;81.1%)BID 治疗的患者达到 PGA 和 PASI75 应答的比例高于安慰剂(19.3%;12.5%;均<0.0001)。第 16 周有应答的患者中,托法替尼 5mg 和 10mg BID 治疗的患者分别有 73.6%和 75.0%维持 PGA 应答,76.8%和 84.9%维持 PASI75 应答至第 52 周。52 周期间,各治疗组有 2.2%-4.5%的患者发生严重不良事件,有 1.1%-6.8%的患者因不良事件停药。

结论

托法替尼在中重度斑块型银屑病亚洲患者中在第 16 周显示出优于安慰剂的疗效;疗效维持至第 52 周。未观察到新的安全性发现。[NCT01815424]

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