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度普利尤单抗治疗可改善中重度特应性皮炎成人患者的生活质量:一项随机、安慰剂对照临床试验的结果。

Dupilumab treatment improves quality of life in adult patients with moderate-to-severe atopic dermatitis: results from a randomized, placebo-controlled clinical trial.

机构信息

Department of Dermatology, University of Münster, Münster, Germany.

Regeneron Pharmaceuticals Inc., Tarrytown, NY, U.S.A.

出版信息

Br J Dermatol. 2018 Feb;178(2):406-414. doi: 10.1111/bjd.15905. Epub 2018 Jan 11.

Abstract

BACKGROUND

Dupilumab, a human anti-interleukin-4 receptor alpha monoclonal antibody, significantly improved clinical signs and symptoms in adults with moderate-to-severe atopic dermatitis in a randomized, double-blind, placebo-controlled, phase IIa trial.

OBJECTIVES

We evaluate health-related quality of life (HRQoL) and correlation of HRQoL with secondary clinical and patient-reported outcomes in a subset of patients from this trial of dupilumab.

METHODS

Patients were randomized to 300 mg weekly subcutaneous dupilumab or placebo for 12 weeks (trial registration: NCT01548404). The Quality of Life Index of Atopic Dermatitis (QoLIAD) score (exploratory outcome) and its correlation with efficacy outcomes [Eczema Area and Severity Index (EASI); primary end point; SCORing Atopic Dermatitis (SCORAD), SCORAD visual analogue scale (VAS) scores for sleep and pruritus, pruritus numerical rating scale (NRS) and 5-dimensional pruritus] were assessed in 64 adults with moderate-to-severe atopic dermatitis.

RESULTS

Mean QoLIAD scores at baseline ± standard error (SE) were 13·3 ± 1·34 and 11·3 ± 1·09 for the placebo and dupilumab groups, respectively. Dupilumab significantly improved QoLIAD score after 12 weeks of treatment vs. placebo (mean % change from baseline in QoLIAD score ± SE: -64·0 ± 6·91 vs. -11·1 ± 9·31). Least squares mean % difference from baseline vs. placebo in QoLIAD score ±SE was -52·0 ± 11·43, P < 0·001). QoLIAD scores significantly correlated with changes in efficacy outcomes, including EASI (r = 0·44), 5-dimensional pruritus (r = 0·49), pruritus NRS (r = 0·41), total SCORAD (r = 0·56) and SCORAD VAS scores for sleep (r = 0·47) and pruritus (r = 0·54); all P < 0·05.

CONCLUSIONS

Dupilumab improved QoLIAD scores in adults with atopic dermatitis and was significantly associated with improvements in study outcomes.

摘要

背景

在一项随机、双盲、安慰剂对照的 IIa 期临床试验中,一种人源化抗白细胞介素-4 受体α单克隆抗体 dupilumab 显著改善了中重度特应性皮炎成人患者的临床体征和症状。

目的

我们评估了该 dupilumab 试验亚组患者的健康相关生活质量 (HRQoL) 以及 HRQoL 与次要临床和患者报告结局的相关性。

方法

患者被随机分配至每周皮下注射 300mg dupilumab 或安慰剂,共 12 周(试验注册:NCT01548404)。特应性皮炎生活质量指数 (QoLIAD) 评分(探索性结局)及其与疗效结局的相关性[湿疹面积和严重程度指数 (EASI);主要终点;特应性皮炎评分 (SCORAD)、SCORAD 视觉模拟量表 (VAS) 评分用于睡眠和瘙痒、瘙痒数字评分量表 (NRS) 和 5 维瘙痒]在 64 例中重度特应性皮炎成人患者中进行评估。

结果

安慰剂和 dupilumab 组的基线时 QoLIAD 评分均值±标准误 (SE) 分别为 13.3±1.34 和 11.3±1.09。与安慰剂相比,12 周治疗后 dupilumab 显著改善 QoLIAD 评分(QoLIAD 评分的基线百分比变化±SE:-64.0±6.91 对-11.1±9.31)。最小二乘均值的 QoLIAD 评分与安慰剂相比的差异百分比±SE 为-52.0±11.43,P<0.001)。QoLIAD 评分与疗效结局的变化显著相关,包括 EASI(r=0.44)、5 维瘙痒(r=0.49)、瘙痒 NRS(r=0.41)、总 SCORAD(r=0.56)和 SCORAD VAS 评分用于睡眠(r=0.47)和瘙痒(r=0.54);所有 P<0.05。

结论

dupilumab 改善了特应性皮炎成人患者的 QoLIAD 评分,且与研究结局的改善显著相关。

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