Sawyer Laura, Fotheringham Iain, Wright Emily, Yasmeen Najeeda, Gibbons Carl, Holmen Møller Anders
a Symmetron Ltd Kinetic Centre , Elstree , UK.
b LEO Pharma UK , Hurley Berkshire , UK.
J Dermatolog Treat. 2018 Sep;29(6):557-568. doi: 10.1080/09546634.2018.1427205. Epub 2018 Jan 29.
To evaluate the relative efficacy of brodalumab compared with approved biologic therapies and apremilast for moderate-to-severe psoriasis.
We searched MEDLINE, Embase, and Cochrane for randomized controlled trials reporting induction phase responses. The primary analysis examined the proportion of patients achieving Psoriasis Area Severity Index (PASI) 50, 75, 90, or 100 responses using a random-effects Bayesian multinomial likelihood model with probit link, with and without adjustment for variation in study-level placebo responses.
A total of 54 studies were included. Based on PASI 100 response, the most efficacious therapies were brodalumab 210 mg every two weeks (Q2W) and ixekizumab. Brodalumab 210 mg Q2W was significantly more efficacious than adalimumab, apremilast, brodalumab 140 mg Q2W, etanercept, infliximab, secukinumab, and ustekinumab. Results were consistent for PASI 50, 75, and 90 outcomes and all sensitivity analyses.
Our findings are consistent with pivotal trials which indicate that high levels of complete clearance can be achieved with brodalumab. Based on existing evidence, induction-phase efficacy of brodalumab is similar to ixekizumab and superior to other approved therapies, including anti-TNFs, apremilast, secukinumab, and ustekinumab.
评估布罗达单抗与已批准的生物疗法及阿普米拉斯相比治疗中重度银屑病的相对疗效。
我们检索了MEDLINE、Embase和Cochrane数据库，以查找报告诱导期反应的随机对照试验。主要分析使用具有概率链接的随机效应贝叶斯多项似然模型，在调整和未调整研究水平安慰剂反应差异的情况下，检查达到银屑病面积和严重程度指数（PASI）50、75、90或100反应的患者比例。
共纳入54项研究。基于PASI 100反应，最有效的疗法是每两周一次210mg的布罗达单抗和司库奇尤单抗。每两周一次210mg的布罗达单抗比阿达木单抗、阿普米拉斯、每两周一次140mg的布罗达单抗、依那西普、英夫利昔单抗、司库奇尤单抗和优特克单抗显著更有效。PASI 50、75和90结果以及所有敏感性分析的结果均一致。
我们的研究结果与关键试验一致，表明布罗达单抗可实现高水平的完全清除。基于现有证据，布罗达单抗诱导期疗效与司库奇尤单抗相似，优于其他已批准的疗法，包括抗TNF药物、阿普米拉斯、司库奇尤单抗和优特克单抗。
