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司库奇尤单抗治疗中重度银屑病患者 5 年,疗效持久且安全性良好(SCULPTURE 扩展研究)。

Secukinumab demonstrates high sustained efficacy and a favourable safety profile in patients with moderate-to-severe psoriasis through 5 years of treatment (SCULPTURE Extension Study).

机构信息

Innovaderm Research, Montreal, QC, Canada.

Department of Dermatology, University of Münster, Münster, Germany.

出版信息

J Eur Acad Dermatol Venereol. 2018 Sep;32(9):1507-1514. doi: 10.1111/jdv.14878. Epub 2018 Mar 22.

Abstract

BACKGROUND

Secukinumab, a fully human monoclonal antibody that selectively neutralizes IL-17A, has been shown to have significant efficacy and a favourable safety profile in the treatment of moderate-to-severe psoriasis and psoriatic arthritis.

OBJECTIVE

To assess the efficacy and safety of secukinumab through 5 years of treatment in moderate-to-severe psoriasis.

METHODS

In the core SCULPTURE study, Psoriasis Area and Severity Index (PASI) 75 responders at Week 12 continued receiving subcutaneous secukinumab until Year 1. Thereafter, patients entered the extension phase and continued treatment as per the core trial. Treatment was double-blinded until the end of Year 3 and open-label from Year 4. Here, we focus on the 300 mg fixed-interval (every 4 weeks) treatment, the recommended per label dose. Efficacy data are primarily reported as observed, but multiple imputation (MI) and last observation carried forward (LOCF) techniques were also undertaken as supportive analyses.

RESULTS

At Year 1, 168 patients entered the extension study and at the end of Year 5, 126 patients completed 300 mg (every 4 weeks) treatment. PASI 75/90/100 responses at Year 1 (88.9%, 68.5% and 43.8%, respectively) were sustained to Year 5 (88.5%, 66.4% and 41%). PASI responses were consistent regardless of the analysis undertaken (as observed, MI, or LOCF). The average improvement in mean PASI was approximately 90% through 5 years compared with core study baseline. DLQI (dermatology life quality index) 0/1 response also sustained through 5 years (72.7% at Year 1 and 65.5% at Year 5). The safety profile of secukinumab remained favourable, with no cumulative or unexpected safety concerns identified.

CONCLUSION

Secukinumab 300 mg treatment delivered high and sustained levels of skin clearance and improved quality of life through 5 years in patients with moderate-to-severe psoriasis. Favourable safety established in the secukinumab phase 2/3 programme was maintained through 5 years.

摘要

背景

司库奇尤单抗是一种全人源单克隆抗体,能选择性中和白细胞介素-17A,在治疗中重度银屑病和银屑病关节炎方面显示出显著的疗效和良好的安全性。

目的

评估司库奇尤单抗在中重度银屑病患者中治疗 5 年的疗效和安全性。

方法

在核心 SCULPTURE 研究中,第 12 周达到 PASI75 应答的银屑病患者继续接受皮下司库奇尤单抗治疗直至第 1 年。此后,患者进入扩展期并按照核心试验继续治疗。治疗在第 3 年末结束时进行双盲,从第 4 年开始进行开放标签。在这里,我们主要关注推荐标签剂量的 300mg 固定间隔(每 4 周)治疗。疗效数据主要以观察结果报告,但也进行了多次插补(MI)和末次观测结转(LOCF)分析作为支持性分析。

结果

第 1 年末,168 名患者进入扩展研究,第 5 年末,126 名患者完成 300mg(每 4 周)治疗。第 1 年(分别为 88.9%、68.5%和 43.8%)达到 PASI75/90/100 应答的患者在第 5 年末(分别为 88.5%、66.4%和 41%)仍持续应答。无论采用何种分析方法(观察值、MI 或 LOCF),PASI 应答均保持一致。与核心研究基线相比,5 年内平均 PASI 改善约 90%。DLQI(皮肤病生活质量指数)0/1 应答在 5 年内也持续(第 1 年为 72.7%,第 5 年为 65.5%)。司库奇尤单抗的安全性状况仍然良好,未发现累积或意外的安全性问题。

结论

在中重度银屑病患者中,司库奇尤单抗 300mg 治疗可在 5 年内持续保持较高水平的皮肤清除率,并改善生活质量。在司库奇尤单抗的 2/3 期研究中确立的良好安全性在 5 年内得到了维持。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eb1a/6175198/5fbfeb9b721d/JDV-32-1507-g001.jpg

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