Furie R, Wang L, Illei G, Drappa J
1 Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Great Neck, NY, USA.
2 MedImmune, LLC, Gaithersburg, MD, USA.
Lupus. 2018 May;27(6):955-962. doi: 10.1177/0961203318758506. Epub 2018 Feb 20.
A post-hoc analysis of pooled data from two Phase IIb trials (sifalimumab; NCT01283139, anifrolumab; NCT01438489) assessed the clinical significance of a Systemic Lupus Erythematosus (SLE) Responder Index (SRI(4)) response (Week 52) for 736 patients with moderate to severe SLE disease activity (study entry). SRI(4) responders achieved significantly greater improvements in clinical outcome measures (including percentages of patients with a ≥ 7-point reduction in SLE Disease Activity Index (SLEDAI)-2000 (2K), British Isles Lupus Assessment Group "A" or "2B" flare rate, and oral corticosteroid reduction to ≤7.5 mg/day; change from baseline in Physician's Global Assessment; and numbers of SLEDAI-2K organ domains with improvement), as well as in patient-reported outcomes (Patient's Global Assessment, Functional Assessment of Chronic Illness Therapy-Fatigue; Short-Form 36 Health Survey Physical Component Summary, Mental Component Summary, Vitality domain scores) vs. nonresponders. Of patients with abnormal serologies, SRI(4) responders had numerically greater improvements (baseline to Week 52) in anti-double-stranded DNA concentrations vs. nonresponders ( p = 0.051), but there were no differences in C3/C4 concentration changes between the two groups. These results confirm previous findings in a different cohort, indicating that an SRI(4) response is associated with global clinical benefit.
一项对两项IIb期试验(西法莫单抗;NCT01283139,阿尼氟单抗;NCT01438489)汇总数据的事后分析,评估了系统性红斑狼疮(SLE)缓解指数(SRI(4))反应(第52周)对736例中度至重度SLE疾病活动患者(研究入组)的临床意义。SRI(4)反应者在临床结局指标(包括SLE疾病活动指数(SLEDAI)-2000(2K)降低≥7分的患者百分比、不列颠群岛狼疮评估组“A”或“2B”级疾病发作率、口服糖皮质激素减量至≤7.5mg/天;医生整体评估较基线的变化;以及SLEDAI-2K改善的器官域数量)方面,以及在患者报告结局(患者整体评估、慢性病治疗功能评估-疲劳;简明健康调查36项身体成分总结、精神成分总结、活力域评分)方面,与无反应者相比有显著更大的改善。在血清学异常的患者中,SRI(4)反应者抗双链DNA浓度(从基线到第52周)较无反应者在数值上有更大改善(p = 0.051),但两组间C3/C4浓度变化无差异。这些结果证实了在不同队列中的先前发现,表明SRI(4)反应与整体临床获益相关。