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巴瑞替尼在日本类风湿性关节炎患者中的疗效和安全性:四项跨国3期随机试验的亚组分析。

Efficacy and safety of baricitinib in Japanese patients with rheumatoid arthritis: Subgroup analyses of four multinational phase 3 randomized trials.

作者信息

Tanaka Yoshiya, Atsumi Tatsuya, Amano Koichi, Harigai Masayoshi, Ishii Taeko, Kawaguchi Osamu, Rooney Terence P, Akashi Naotsugu, Takeuchi Tsutomu

机构信息

a First Department of Internal Medicine, School of Medicine , University of Occupational and Environmental Health , Kitakyushu , Japan.

b Division of Rheumatology, Endocrinology and Nephrology, Graduate School of Medicine , Hokkaido University , Hokkaido , Japan.

出版信息

Mod Rheumatol. 2018 Jul;28(4):583-591. doi: 10.1080/14397595.2017.1392057. Epub 2017 Nov 14.

Abstract

OBJECTIVES

To evaluate efficacy/safety of baricitinib for rheumatoid arthritis (RA) in Japanese subpopulations from four phase 3 studies, and assess whether results in these subpopulations are consistent with the overall study populations.

METHODS

Subgroup analyses (394 patients) of four phase 3 randomized controlled trials: RA-BEGIN [no or limited treatment with disease-modifying antirheumatic drugs (DMARDs)], RA-BEAM [inadequate response (IR) to methotrexate], RA-BUILD [IR to conventional synthetic DMARDs (csDMARDs)], and RA-BEACON (IR to tumor necrosis factor inhibitors receiving csDMARDs).

RESULTS

For American College of Rheumatology 20% improvement (ACR20) response rate, Japanese patients receiving baricitinib 4-mg showed similar improvement compared to methotrexate at Week 24 (72 versus 69%; RA-BEGIN), and greater improvement compared with placebo at Week 12 (67 versus 34%; RA-BEAM). Japanese patients receiving baricitinib 4-mg also showed greater improvement compared with placebo at Week 12 in RA-BUILD and RA-BEACON. Across all studies, baricitinib was well-tolerated, with no deaths and one malignancy. In RA-BEGIN and RA-BEAM, herpes zoster rates were higher for Japanese patients than for overall populations; all events were mild/moderate.

CONCLUSION

Data for baricitinib, with/without methotrexate, in Japanese subpopulations across all stages of the RA treatment continuum accord with the efficacy/safety profile in overall study populations. Baricitinib appears to be similarly effective in Japanese patients.

摘要

目的

在四项3期研究的日本亚组人群中评估巴瑞替尼治疗类风湿性关节炎(RA)的疗效/安全性,并评估这些亚组人群的结果是否与总体研究人群一致。

方法

对四项3期随机对照试验进行亚组分析(394例患者):RA - BEGIN[未使用或仅有限使用改善病情抗风湿药物(DMARDs)]、RA - BEAM[对甲氨蝶呤反应不足(IR)]、RA - BUILD[对传统合成DMARDs(csDMARDs)反应不足]以及RA - BEACON[对接受csDMARDs的肿瘤坏死因子抑制剂反应不足]。

结果

对于美国风湿病学会20%改善(ACR20)反应率,接受4毫克巴瑞替尼的日本患者在第24周时与甲氨蝶呤相比显示出相似的改善(分别为72%和69%;RA - BEGIN),在第12周时与安慰剂相比有更大改善(分别为67%和34%;RA - BEAM)。接受4毫克巴瑞替尼的日本患者在RA - BUILD和RA - BEACON研究的第12周时与安慰剂相比也有更大改善。在所有研究中,巴瑞替尼耐受性良好,无死亡病例,仅有1例恶性肿瘤。在RA - BEGIN和RA - BEAM中,日本患者的带状疱疹发生率高于总体人群;所有事件均为轻度/中度。

结论

在RA治疗连续统一体所有阶段的日本亚组人群中,无论是否联合甲氨蝶呤使用巴瑞替尼的数据均与总体研究人群的疗效/安全性特征相符。巴瑞替尼在日本患者中似乎同样有效。

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