Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
Institute for Health Services Research in Dermatology and Nursing University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
J Am Acad Dermatol. 2018 Apr;78(4):741-748. doi: 10.1016/j.jaad.2017.10.025. Epub 2017 Oct 21.
BACKGROUND: Secukinumab has demonstrated greater sustained skin clearance than ustekinumab through week 52, greater improvement in symptoms and health-related quality of life, and comparable safety profile. OBJECTIVE: To assess the impact of secukinumab versus that of ustekinumab on complete relief from psoriasis-related symptoms, time to response in terms of health-related quality of life, and cumulative benefit among patients with moderate-to-severe plaque psoriasis. METHODS: Psoriasis-related pain, itching, and scaling and the Dermatology Life Quality Index (DLQI) score were compared between treatments on the basis of time to complete relief of symptoms and time to DLQI response in the CLEAR trial. Cumulative benefit over 52 weeks based on Psoriasis Area and Severity Index score, symptom relief, and DLQI response were evaluated by area under the curve analysis. RESULTS: Significantly more patients treated with secukinumab achieved complete relief of pain at weeks 16 and 52 (all P < .05). Complete relief of itching and scaling occurred significantly faster with secukinumab (median, 4 weeks faster for itching and 8 weeks faster for scaling [P < .001]). Response as measured by the DLQI was 4 weeks faster with secukinumab (P < .0001). Cumulative benefits were greater with secukinumab (all P < .05). LIMITATIONS: Analyses were post hoc. CONCLUSION: This patient-reported outcome analysis confirms greater and sustained benefits of secukinumab versus those of ustekinumab treatment on patients' lives.
背景:司库奇尤单抗在第 52 周时表现出比乌司奴单抗更持久的皮肤清除效果,在症状和健康相关生活质量方面有更大的改善,且安全性相似。
目的:评估司库奇尤单抗与乌司奴单抗对中重度斑块状银屑病患者的银屑病相关症状完全缓解、健康相关生活质量应答时间以及累积获益的影响。
方法:基于 CLEAR 试验中症状完全缓解时间和皮肤病生活质量指数(DLQI)应答时间,比较两种治疗方法在银屑病相关疼痛、瘙痒和脱屑以及 DLQI 评分方面的差异。通过曲线下面积分析评估 52 周时基于银屑病面积和严重程度指数评分、症状缓解和 DLQI 应答的累积获益。
结果:接受司库奇尤单抗治疗的患者在第 16 周和第 52 周时达到疼痛完全缓解的比例显著更高(均 P<.05)。瘙痒和脱屑的完全缓解更快(瘙痒时的中位数快 4 周,脱屑时的中位数快 8 周[P<.001])。司库奇尤单抗的 DLQI 应答更快(P<.0001)。司库奇尤单抗的累积获益更大(均 P<.05)。
局限性:分析为事后分析。
结论:这一基于患者报告结局的分析结果证实,司库奇尤单抗治疗在患者生活质量方面具有更大和更持久的获益,优于乌司奴单抗治疗。
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