McInnes Iain B, Mease Philip J, Ritchlin Christopher T, Rahman Proton, Gottlieb Alice B, Kirkham Bruce, Kajekar Radhika, Delicha Eumorphia-Maria, Pricop Luminita, Mpofu Shephard
Institute of Infection Immunity and Inflammation, University of Glasgow, Glasgow, UK.
Division of Rheumatology Clinical Research, Swedish Medical Centre and University of Washington, Seattle, WA.
Rheumatology (Oxford). 2017 Nov 1;56(11):1993-2003. doi: 10.1093/rheumatology/kex301.
To assess long-term efficacy, safety and tolerability of secukinumab up to 104 weeks in patients with active PsA.
Patients with PsA (n = 397) were randomized to s.c. secukinumab 300, 150 or 75 mg or placebo at baseline, weeks 1, 2, 3 and 4 and every 4 weeks thereafter. Placebo-treated patients were re-randomized to receive secukinumab 300 or 150 mg s.c. from week 16 (placebo non-responders) or week 24 (placebo responders). Exploratory endpoints at week 104 included 20, 50 and 70% improvement in ACR criteria (ACR20, 50, 70); 75 and 90% improvement in the Psoriasis Area Severity Index, 28-joint DAS with CRP, presence of dactylitis and enthesitis and other patient-reported outcomes. For binary variables, missing values were imputed; continuous variables were analysed by a mixed-effects model for repeated measures.
A total of 86/100 (86%), 76/100 (76%) and 65/99 (66%) patients in the secukinumab 300, 150 and 75 mg groups, respectively, completed 104 weeks. At week 104, ACR20 response rates after multiple imputation in the 300, 150 and 75 mg groups were 69.4, 64.4 and 50.3%, respectively. Sustained clinical improvements were observed through week 104 with secukinumab across other clinically important domains of PsA. Responses were sustained through week 104 regardless of prior anti-TNF-α use. Over the entire treatment period the incidence, type and severity of adverse events were consistent with those reported previously.
Secukinumab provided sustained improvements in signs and symptoms and multiple clinical domains in patients of active PsA through 2 years of therapy. Secukinumab was well tolerated, with a safety profile consistent with that reported previously.
ClinicalTrials.gov (https://clinicaltrials.gov), NCT01752634.
评估司库奇尤单抗治疗活动性银屑病关节炎(PsA)患者长达104周的长期疗效、安全性和耐受性。
将397例PsA患者在基线、第1、2、3和4周以及此后每4周随机分为皮下注射司库奇尤单抗300、150或75mg组或安慰剂组。接受安慰剂治疗的患者在第16周(安慰剂无反应者)或第24周(安慰剂反应者)重新随机分组,接受皮下注射司库奇尤单抗300或150mg。第104周的探索性终点包括美国风湿病学会(ACR)标准中20%、50%和70%的改善(ACR20、50、70);银屑病面积和严重程度指数改善75%和90%,28个关节疾病活动度评分(DAS28)联合C反应蛋白(CRP),指(趾)炎和附着点炎的存在情况以及其他患者报告的结局。对于二元变量,缺失值进行插补;连续变量采用重复测量的混合效应模型进行分析。
司库奇尤单抗300mg、150mg和75mg组分别有86/100(86%)、76/100(76%)和65/99(66%)的患者完成了104周的治疗。在第104周,300mg、150mg和75mg组多次插补后的ACR20缓解率分别为69.4%、64.4%和50.3%。在PsA的其他重要临床领域,司库奇尤单抗在第104周均观察到持续的临床改善。无论先前是否使用过抗TNF-α药物,缓解情况均持续至第104周。在整个治疗期间,不良事件的发生率、类型和严重程度与先前报告的一致。
司库奇尤单抗在2年的治疗中为活动性PsA患者的体征、症状和多个临床领域提供了持续改善。司库奇尤单抗耐受性良好,安全性与先前报告一致。
ClinicalTrials.gov(https://clinicaltrials.gov),NCT01752634。