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托法替布联合传统合成改善病情抗风湿药用于中国类风湿关节炎患者:3期随机对照试验的患者报告结局

Tofacitinib with conventional synthetic disease-modifying antirheumatic drugs in Chinese patients with rheumatoid arthritis: Patient-reported outcomes from a Phase 3 randomized controlled trial.

作者信息

Li Zhanguo, An Yuan, Su Houheng, Li Xiangpei, Xu Jianhua, Zheng Yi, Li Guiye, Kwok Kenneth, Wang Lisy, Wu Qizhe

机构信息

Peking University People's Hospital, Beijing, China.

Qingdao Municipal Hospital, Qingdao, China.

出版信息

Int J Rheum Dis. 2018 Feb;21(2):402-414. doi: 10.1111/1756-185X.13244. Epub 2018 Jan 4.

Abstract

AIM

Tofacitinib is an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis (RA). We assess the effect of tofacitinib + conventional synthetic disease-modifying anti rheumatic drugs (csDMARDs) on patient-reported outcomes in Chinese patients with RA and inadequate response to DMARDs.

METHODS

This analysis of data from the Phase 3 study ORAL Sync included Chinese patients randomized 4 : 4 : 1 : 1 to receive tofacitinib 5 mg twice daily, tofacitinib 10 mg twice daily, placebo→tofacitinib 5 mg twice daily, or placebo→tofacitinib 10 mg twice daily, with csDMARDs. Placebo non-responders switched to tofacitinib at 3 months; the remaining placebo patients switched at 6 months. Least squares mean changes from baseline were reported for Health Assessment Questionnaire-Disability Index (HAQ-DI), patient assessment of arthritis pain (Pain), patient global assessment of disease activity (PtGA), physician global assessment of disease activity (PGA), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) scores, Short Form 36 (SF-36), and Work Limitations Questionnaire (WLQ), using a mixed-effects model for repeated measures.

RESULTS

Overall, 216 patients were included (tofacitinib 5 mg twice daily, n = 86; tofacitinib 10 mg twice daily, n = 86; placebo→tofacitinib 5 mg twice daily, n = 22; placebo→tofacitinib 10 mg twice daily, n = 22). At month 3, tofacitinib elicited significant improvements in HAQ-DI, Pain, PtGA, PGA and SF-36 Physical Component Summary scores. Improvements were generally maintained through 12 months.

CONCLUSION

Tofacitinib 5 and 10 mg twice daily + csDMARDs resulted in improvements in health-related quality of life, physical function and Pain through 12 months in Chinese patients with RA.

摘要

目的

托法替布是一种用于治疗类风湿关节炎(RA)的口服Janus激酶抑制剂。我们评估托法替布联合传统合成改善病情抗风湿药(csDMARDs)对中国RA患者且对DMARDs反应不足的患者报告结局的影响。

方法

这项对3期研究ORAL Sync数据的分析纳入了中国患者,他们按4:4:1:1随机分组,分别接受每日两次5毫克托法替布、每日两次10毫克托法替布、安慰剂→每日两次5毫克托法替布或安慰剂→每日两次10毫克托法替布,并联合csDMARDs。安慰剂无反应者在3个月时换用托法替布;其余安慰剂患者在6个月时换用。使用重复测量的混合效应模型报告健康评估问卷残疾指数(HAQ-DI)、患者对关节炎疼痛的评估(疼痛)、患者对疾病活动的整体评估(PtGA)、医生对疾病活动的整体评估(PGA)、慢性病治疗功能评估-疲劳(FACIT-F)评分、简明健康状况调查量表(SF-36)和工作限制问卷(WLQ)相对于基线的最小二乘均值变化。

结果

总体而言,共纳入216例患者(每日两次5毫克托法替布组,n = 86;每日两次10毫克托法替布组,n = 86;安慰剂→每日两次5毫克托法替布组,n = 22;安慰剂→每日两次10毫克托法替布组,n = 22)。在第3个月时,托法替布使HAQ-DI、疼痛、PtGA、PGA和SF-36身体成分总结评分有显著改善。这些改善通常维持到12个月。

结论

每日两次5毫克和10毫克托法替布联合csDMARDs可使中国RA患者在12个月内健康相关生活质量、身体功能和疼痛得到改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7109/5817244/9439697e915c/APL-21-402-g001.jpg

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