Innovaderm Research Inc, Montréal, QC, Canada.
Department of Dermatology, University of Münster, Münster, Germany.
Br J Dermatol. 2017 Oct;177(4):1033-1042. doi: 10.1111/bjd.15706. Epub 2017 Sep 4.
Secukinumab has demonstrated significant efficacy with a good safety profile through 1 year in plaque psoriasis. Given the chronic nature of this disease, long-term follow-up is needed to evaluate psoriasis therapies fully.
To determine the long-term (3-year) efficacy and safety of secukinumab in moderate-to-severe psoriasis.
Patients completing 52 weeks of secukinumab treatment in the SCULPTURE core study entered an extension in which they continued the same double-blind regimens. Dosing regimens included a fixed-interval schedule (FI; every 4 weeks) and retreatment as needed (RAN), in which patients were withdrawn from secukinumab and received placebo until the start of relapse, at which time secukinumab every 4 weeks was reinitiated. The study was registered with number NCT01640951.
In total 168 patients receiving secukinumab 300 mg FI and 172 receiving secukinumab 300 mg RAN entered the extension. Secukinumab 300 mg FI sustained high efficacy: at the end of year 3, the proportion of responders achieving ≥ 90% improvement in Psoriasis Area and Severity Index (PASI 90) was 63·8%, and of PASI 100 responders it was 42·6%. The mean absolute PASI remained low (2-4) from week 52 to week 152 with 300 mg FI, with approximately two-thirds of patients reporting no impact of skin disease on their lives (Dermatology Life Quality Index of 0 or 1). Improvements in overall and subscale scores on all quality-of-life instruments were well sustained. As in the core study, FI dosing was consistently more efficacious than RAN. No new safety signals were identified to year 3.
Secukinumab 300 mg FI sustained high responses and improved quality of life with no new safety concerns through 3 years.
司库奇尤单抗在斑块状银屑病中表现出显著的疗效和良好的安全性,为期 1 年。鉴于这种疾病的慢性性质,需要长期随访来全面评估银屑病的治疗方法。
确定司库奇尤单抗治疗中重度银屑病的长期(3 年)疗效和安全性。
在 SCULPTURE 核心研究中完成 52 周司库奇尤单抗治疗的患者进入扩展期,继续接受相同的双盲治疗方案。治疗方案包括固定间隔方案(FI;每 4 周)和按需治疗(RAN),在 RAN 中,患者停止使用司库奇尤单抗并接受安慰剂,直到复发开始,此时开始每 4 周重新使用司库奇尤单抗。该研究在 NCT01640951 号注册。
共有 168 例接受司库奇尤单抗 300mg FI 和 172 例接受司库奇尤单抗 300mg RAN 的患者进入扩展期。司库奇尤单抗 300mg FI 持续保持高疗效:在第 3 年结束时,达到 90%以上的改善(PASI90)的应答者比例为 63.8%,达到 PASI100 的应答者比例为 42.6%。FI 治疗的平均绝对 PASI 从第 52 周到第 152 周仍保持较低水平(2-4),约三分之二的患者报告皮肤疾病对其生活没有影响(皮肤病生活质量指数为 0 或 1)。所有生活质量量表的总分和子量表评分的改善均得到良好维持。与核心研究一样,FI 治疗的疗效始终优于 RAN。到第 3 年未发现新的安全性信号。
司库奇尤单抗 300mg FI 持续保持高应答和改善生活质量,且无新的安全性担忧,持续 3 年。